Miracle-dz/UniFAR-FTUs huggingface dataset:
Pointing Device Usage Guidelines for People With Quadriplegia: A Simulation and Validation Study Utilizing an Integrated Pointing Device Apparatus

This study undertakes a simulation and validation experiment to provide guidelines regarding pointing device usage for quadriplegic individuals assisted by a newly developed integrated pointing device apparatus (IPDA). The simulation experiment involving 30 normal subjects whose upper limb movement was restricted by splints. Another 15 subjects with high level cervical spinal cord injury (SCI) were recruited for the validation study. All normal subjects employed six control modes for target-acquisition and drag-and-drop tasks using an IPDA to integrate common pointing devices. A previously designed software was used to evaluate the operational efficiency (OE), expressed as ldquoable performancerdquo (% AP), of the subjects. The experimental results indicated that the OE of normal subjects for controlling the pointing devices were dominated first by using the unilateral hand (69-100 % AP), then by using the wrist/hand (65-73 % AP), and finally by using either bilateral body parts or the combination of limb and chin (45-53 % AP). The OE for operating an orientation-rotated mouse using the dominant wrist/hand via IPDA in both tasks was equivalent to that for operating a trackball using the dominant hand. The experimental results obtained by subjects with SCI also demonstrated similar findings, although the OEs in each control mode were lower than in normal subjects. Results of this study provide valuable guidelines for selecting and integrating common pointing devices using IPDA for quadriplegic individuals. The priority for selecting which body part should control the pointing devices was as follows: unilateral hands, unilateral wrist/hands, and either bilateral body parts or a limb and chin/head/neck in combination.
Humans Can Integrate Force Feedback to Toes in Their Sensorimotor Control of a Robotic Hand

Tactile sensory feedback is essential for dexterous object manipulation. Users of hand myoelectric prostheses without tactile feedback must depend essentially on vision to control their device. Indeed, improved tactile feedback is one of their main priorities. Previous research has provided evidence that conveying tactile feedback can improve prostheses control, although additional effort is required to solve problems related to pattern recognition learning, unpleasant sensations, sensory adaptation, and low spatiotemporal resolution. Still, these studies have mainly focused on providing stimulation to hairy skin regions close to the amputation site, i.e., usually to the upper arm. Here, we explored the possibility to provide tactile feedback to the glabrous skin of toes, which have mechanical and neurophysiological properties similar to the fingertips. We explored this paradigm in a grasp-and-lift task, in which healthy participants controlled two opposing digits of a robotic hand by changing the spacing of their index finger and thumb. The normal forces applied by the robotic fingertips to a test object were fed back to the right big and second toe. We show that within a few lifting trials, all the participants incorporated the force feedback received by the foot in their sensorimotor control of the robotic hand.
Randomized Controlled Trial of Truncal Exercises Early After Stroke to Improve Balance and Mobility

Background. Sitting balance and the ability to perform selective truncal movements are important predictors of functional outcome after stroke. However, few clinical trials have evaluated the effect of truncal exercises. Objective. The authors assessed the effect of additional truncal exercises on truncal function, standing balance, and mobility. Methods. An assessor-blinded randomized controlled trial was carried out at a stroke rehabilitation hospital. A total of 33 participants (mean 35 days post onset) were randomly assigned to an experimental group (n = 18) or a control group (n = 15). In addition to conventional therapy, the experimental group received 16 hours of truncal exercises. The control group received 16 hours of sham treatment. Truncal function was evaluated by the Trunk Impairment Scale (TIS) and standing balance and mobility by the Tinetti Test. The Romberg with eyes open and eyes closed, Four Test Balance Scale (FTBS), Berg Balance Scale (BBS), Rivermead Motor Assessment Battery (RMAB), Functional Ambulation Categories, and Dynamic Gait Index (DGI) were performed to elucidate the findings of the primary outcome measures. Results. A treatment effect was found for the experimental group on the TIS (P < .001), Tinetti Test (P < .001), FTBS (P = .014), BBS (P = .007), RMAB (P < .001), and DGI (P = .006). Conclusions. In addition to conventional therapy, truncal exercises have a beneficial effect on truncal function, standing balance, and mobility in people after stroke.
Free-tagging methods for opinion analysis of online news comments

To overcome challenges of processing timeliness and changeful topics when analyzing opinions of online news comments, free-tagging methods including two steps, object identification and polarity analysis, are proposed in this paper. In the first step, from news text, we employ the Affinity Propagation Cluster (APC) to extract key sentences whose name entities will be identified and their specified types will be identified as comment objects. After identifying comment objects, the method of distance-weight count of polarized words and semantic rules are used to determine the polarity of comments. Our method does not require labeled corpus, therefore it can reduce artificial workloads and avoid problems of non-versatility caused by changeful topics of comments. Experiment results show that our method is capable of identifying objects and polarity of online news comments with higher precision and wide coverage rate, and can satisfy the requirements of online news comments analysis.
Transcranial Magnetic Stimulation Combined With Physiotherapy in Rehabilitation of Poststroke Hemiparesis

Background. Low-frequency repetitive transcranial magnetic stimulation (rTMS) of the contralesional primary motor cortex (M1) may improve recovery in patients with hemiparetic stroke. Objective. To evaluate the effectiveness of applying 1 Hz rTMS to the contralesional M1 in addition to physiotherapy during early rehabilitation for stroke patients with hand hemiparesis in a randomized, sham-controlled, double-blind study. Methods. Forty patients with moderate upper extremity hemiparesis were randomized to receive 3 weeks of motor training (45 minutes daily) preceded by 30 minutes of 1 Hz rTMS applied to the contralesional M1 or 30 minutes of sham rTMS. Functional assessment of the paretic hand using the Wolf Motor Function Test was performed before, immediately after, and 3 months after completing treatment. Results. No statistically significant differences were found between the experimental and the control group for hand function (Wolf Motor Function Test; P = .92) or the level of neurological deficit (National Institutes of Health Stroke Scale [NIHSS]; P = .82) after treatment. Effect sizes for the experimental (d = 0.5) and the control group (d = 0.47) were small. Similar results were observed at the 3-month follow-up. Conclusions. The findings did not suggest that rTMS suppression of the contralesional motor cortex augments the effect of early neurorehabilitation for upper limb hemiparesis. Larger trials that stratify subjects based on residual motor function or physiological measures of excitation and inhibition may identify responders in the future.
Eccentric Versus Concentric Resistance Training to Enhance Neuromuscular Activation and Walking Speed Following Stroke

Background. Impaired voluntary neuromuscular activation of agonist muscles is a primary determinant of weakness and motor dysfunction following stroke. Objective. To determine whether eccentric resistance training (ECC) resistance training is superior to concentric resistance training (CON) resistance training to enhance neuromuscular activation, strength, and walking speed after stroke. Methods. A total of 34 adults poststroke participated in a staged intervention comprising (1) either CON-only or ECC-only resistance training of the paretic leg followed by (2) gait training. Changes in voluntary neuromuscular activation and power were assessed for both the trained paretic and untrained nonparetic legs. Self-selected and fast walking speeds were also assessed. Results. In response to resistance training, the ECC group experienced larger improvements in neuromuscular activation of paretic leg muscles, rectus femoris and vastus medialis (P < .005), and the largest gains in paretic leg power (+74% for ECC contractions, P < .0001). ECC also had greater cross-education of increased power to the untrained nonparetic leg (12%-14%, P = .006). Over the course of gait training, much of the gain in paretic leg activation in the ECC group was lost, such that the net change in agonist activation was comparable between the CON and ECC groups when the full intervention was completed. Nevertheless, improvement in walking speed postintervention was more prevalent in the ECC than CON group. Conclusion. ECC resistance training was more effective for improving bilateral neuromuscular activation, strength, and walking speed following stroke. Future research should assess whether a longer duration ECC training program can provide further benefit.
A Standardized Approach to the Fugl-Meyer Assessment and Its Implications for Clinical Trials

Background. Standardizing scoring reduces variability and increases accuracy. A detailed scoring and training method for the Fugl-Meyer motor assessment (FMA) is described and assessed, and implications for clinical trials considered. Methods. A standardized FMA scoring approach and training materials were assembled, including a manual, scoring sheets, and instructional video plus patient videos. Performance of this approach was evaluated for the upper extremity portion. Results. Inter- and intrarater reliability in 31 patients were excellent (intraclass correlation coefficient = 0.98-0.99), validity was excellent (r = 0.74-0.93, P < .0001), and minimal detectable change was low (3.2 points). Training required 1.5 hours and significantly reduced error and variance among 50 students, with arm FMA scores deviating from the answer key by 3.8 ± 6.2 points pretraining versus 0.9 ± 4.9 points posttraining. The current approach was implemented without incident into training for a phase II trial. Among 66 patients treated with robotic therapy, change in FMA was smaller (P ≤ .01) at the high and low ends of baseline FMA scores. Conclusions. Training with the current method improved accuracy, and reduced variance, of FMA scoring; the 20% FMA variance reduction with training would decrease sample size requirements from 137 to 88 in a theoretical trial aiming to detect a 7-point FMA difference. Minimal detectable change was much smaller than FMA minimal clinically important difference. The variation in FMA gains in relation to baseline FMA suggests that future trials consider a sliding outcome approach when FMA is an outcome measure. The current training approach may be useful for assessing motor outcomes in restorative stroke trials.
Arm Stiffness During Assisted Movement After Stroke: The Influence of Visual Feedback and Training

Spasticity and muscular hypertonus are frequently found in stroke survivors and may have a significant effect on functional impairment. These abnormal neuro-muscular properties, which are quantifiable by the net impedance of the hand, have a direct consequence on arm mechanics and are likely to produce anomalous motor paths. Literature studies quantifying limb impedance in stroke survivors have focused on multijoint static tasks and single joint movements. Despite this research, little is known about the role of sensory motor integration in post-stroke impedance modulation. The present study elucidates this role by integrating an evaluation of arm impedance into a robotically mediated therapy protocol. Our analysis had three specific objectives: 1) obtaining a reliable measure for the mechanical proprieties of the upper limb during robotic therapy; 2) investigating the effects of robot-assisted training and visual feedback on arm stiffness and viscosity; 3) determining if the stiffness measure and its relationship with either training or visual feedback depend on arm position, speed, and level of assistance. This work demonstrates that the performance improvements produced by minimally assistive robot training are associated with decreased viscosity and stiffness in stroke survivors' paretic arm and that these mechanical impedance components are partially modulated by visual feedback.
Energy Expenditure and Exercise Intensity of Interactive Video Gaming in Individuals Poststroke

Background. Off-the-shelf activity-promoting video games (AVGs) are proposed as a tool for promoting regular physical activity among individuals poststroke. Objective. To characterize the energy expenditure (EE), exercise intensity, and energy metabolism of individuals poststroke, while playing AVGs in different positions, from different consoles, and to compare the performance with comfortable walking and with able-bodied individuals. Methods. Eleven poststroke and 8 able-bodied participants played in standing Wii-Boxing Xbox-Boxing, Wii-Run and Penguin, and also Wii-Boxing in sitting. EE (expressed as metabolic equivalents [METs]); exercise intensity (expressed as %predicted maximal heart rate [HR]), rate of perceived exertion (RPE), and respiratory exchange ratio (RER) were used to characterize the games. Results. Participants’ poststroke EE ranged from 1.81 ± 0.74 to 3.46 ± 1.3 METs and was lower compared with able-bodied participants for Xbox-Boxing (P = .001), Wii-Boxing in standing (P = .01), Run (P < .001), and Penguin (P = .001). Participants’ poststroke exercise intensity ranged from 49.8 ± 9.3 to 64.7 ± 9.3 %predicted maximal HR and was lower compared with able-bodied participants for Xbox-Boxing (P = .007) and Run (P = .005). For participants poststroke, EE of walking at a comfortable did not differ from boxing games in standing or Run. For able-bodied participants only, the EE for Xbox-Boxing was higher than Wii-Boxing (6.5 ± 2.6 vs 4.4 ± 1.1, P = .02). EE was higher in standing versus sitting for poststroke (P = .04) and able-bodied (P = .03) participants. There were no significant group differences for RPEs. RER of playing in sitting approached anaerobic metabolism. Conclusions. Playing upper extremity (ie, Boxing) or mobility (ie, Run) AVGs in standing resulted in moderate EE and intensity for participants poststroke. EE was lower for poststroke than for able-bodied participants.
Pulmonary arterial hypertension related to HIV infection: a systematic review of the literature comprising 192 cases

ABSTRACT Objective: HIV infection is a well-recognised risk factor for pulmonary arterial hypertension (PAH). In order to evaluate the influence of highly active antiretroviral therapy on the development of PAH in HIV infection (APAH‐HIV), we performed a systematic review of published literature contributing to the topic. Methods: Relevant publications were retrieved by a comprehensive literature search in major medical databases including Medline, AIDSinfo, AIDSline, Cochrane Library of Systematic Reviews, Database of Abstracts of Reviews of Effects, Health Technology Assessment Database, Healthstar and European Database on AIDS and HIV Infection. Inclusion criteria were studies on adult patients with HIV and PAH. The search of the literature was followed by standardised information extraction and analysis with reference to clinical characteristics, diagnostic procedures, therapy and outcome. Results: The majority of identified publications related to APAH‐HIV reported case reports. Among 192 identified reports, 57% of the patients were male (mean age: 36 ± 7.6 years). Intravenous drug abuse was the most common causal factor for HIV infection (53%). At the time of diagnosis of PAH, the patients had a mean CD4 count of 355 cells/µl (SD 276) and were almost equally distributed over all stages of HIV infection. Two-thirds of the patients were in NYHA stages III and IV at the time of diagnosis. Echocardiography and right heart catheterisation showed right ventricular dilation in 85% and a mean pulmonary vascular resistance of 1001 dyn·s·cm−5 (SD 418), respectively. Therapy included specific vasodilators in 32.0% of the patients. The 1-year survival rate estimated with Kaplan–Meier statistics was 50%. Cardio-pulmonary complications were the most frequent cause of death (77%). Conclusion: PAH is a devastating complication of HIV infection. Patients with PAH do not die of opportunistic infections or malignancies but of right heart failure. Therefore, research should concentrate on diagnosis and treatment options for APAH‐HIV patients.
Logic verification using binary decision diagrams in a logic synthesis environment

The results of a formal logic verification system implemented as part of the multilevel logic synthesis system MIS are discussed. Combinational logic verification involves checking two networks for functional equivalence. Techniques that flatten networks or use cube enumeration and simulation cannot be used with functions that have very large cube covers. Binary decision diagrams (BDDs) are canonical representations for Boolean functions and offer a technique for formal logic verification. However, the size of BDDs is sensitive to the variable ordering. Ordering strategies based on the network topology are considered. Using these strategies with BDDs, it has been possible to carry out formal verification for a larger set of networks than with existing verification systems. The present method proved significantly faster on the benchmark set of examples tested. <<ETX>>
Vectorized fault simulation on the Cray X-MP supercomputer

A highly vectorized parallel fault simulation (VPFS) algorithm developed to take advantage of the specific hardware architecture of the Cray X-MP is described. The data structure is optimized to suit the constraints imposed by the design of the main memory on the Cray supercomputer. The implementation of VPFS on a Cray X-MP/24 achieved a peak performance of about 2.5*10/sup 9/ gate evaluations per second on one processor, for a maximal speedup of approximately=30 over scalar processing. <<ETX>>
Assist-as-Needed Robot-Aided Gait Training Improves Walking Function in Individuals Following Stroke

A novel robot-aided assist-as-needed gait training paradigm has been developed recently. This paradigm encourages subjects' active participation during training. Previous pilot studies demonstrated that assist-as-needed robot-aided gait training (RAGT) improves treadmill walking performance post-stroke. However, it is not known if there is an over-ground transfer of the training effects from RAGT on treadmill or long-term retention of the effects. The purpose of the current study was to examine the effects of assist-as-needed RAGT on over-ground walking pattern post-stroke. Nine stroke subjects received RAGT with visual feedback of each subject's instantaneous ankle malleolus position relative to a target template for 15 40-minute sessions. Clinical evaluations and gait analyses were performed before, immediately after, and 6 months post-training. Stroke subjects demonstrated significant improvements and some long-term retention of the improvements in their self-selected over-ground walking speed, Dynamic Gait Index, Timed Up and Go, peak knee flexion angle during swing phase and total hip joint excursion over the whole gait cycle for their affected leg . These preliminary results demonstrate that subjects improved their over-ground walking pattern and some clinical gait measures post-training suggesting that assist-as-needed RAGT including visual feedback may be an effective approach to improve over-ground walking pattern post-stroke.
Clinical Gait Analysis: Comparing Explicit State Duration HMMs Using a Reference-Based Index

In clinical gait analysis, the gait of a patient is recorded with optical motion capture and compared with a healthy reference group. High-dimensional gait datasets are difficult to interpret; machine learning can provide guidance regarding the most relevant gait phases and joint angles for visual analysis and quantify the difference between healthy and pathological gait. We propose an explicit state duration hidden Markov model (HMM) modeling the timeseries data of a subject or a group and the use of a reference-based measure that compares the most likely observations in each state. Based on this stochastic framework, the similarity between healthy and pathological gait can be quantified for each state, each joint angle, and each subject. This concept also includes an overall gait index useful for group comparison or the assessment of an individual's gait. For visualization, joint angle timeseries can be generated from the explicit state duration HMM. The accuracy of the explicit state duration HMM and the performance of the reference-based measures are evaluated on a dataset including strides of healthy subjects and patients suffering from arthritis.
Combining Multiple Types of Motor Rehabilitation Enhances Skilled Forelimb Use Following Experimental Traumatic Brain Injury in Rats

Background. Neuroplasticity and neurorehabilitation have been extensively studied in animal models of stroke to guide clinical rehabilitation of stroke patients. Similar studies focused on traumatic brain injury (TBI) are lacking. Objective. The current study was designed to examine the effects of individual and combined rehabilitative approaches, previously shown to be beneficial following stroke, in an animal model of moderate/severe TBI, the controlled cortical impact (CCI). Methods. Rats received a unilateral CCI, followed by reach training, voluntary exercise, or unimpaired forelimb constraint, alone or in combination. Forelimb function was assessed at different time points post-CCI by tests of skilled reaching, motor coordination, and asymmetrical limb use. Results. Following CCI, skilled reaching and motor coordination were significantly enhanced by combinations of rehabilitation strategies, not by individual approaches. The return of symmetrical limb use benefited from forelimb constraint alone. None of the rehabilitation strategies affected the size of injury, suggesting that enhanced behavioral function was not a result of neuroprotection. Conclusions. The current study has provided evidence that individual rehabilitation strategies shown to be beneficial in animal models of stroke are not similarly sufficient to enhance behavioral outcome in a model of TBI. Motor rehabilitation strategies for TBI patients may need to be more intense and varied. Future basic science studies exploring the underlying mechanisms of combined rehabilitation approaches in TBI as well as clinical studies comparing rehabilitation approaches for stroke versus TBI would prove fruitful.
Resolution of Secondary Chlamydia trachomatis Genital Tract Infection in Immune Mice with Depletion of Both CD4+ and CD8+ T cells

ABSTRACT The essential role of T cells in the resolution of primary murineChlamydia trachomatis genital tract infection is inarguable; however, much less is known about the mechanisms that confer resistance to reinfection. We previously established that CD4+ T cells and B cells contribute importantly to resistance to reinfection. In our current studies, we demonstrate that immune mice concurrently depleted of both CD4+ T cells and CD8+ T cells resisted reinfection as well as immunocompetent wild-type mice. The in vivo depletion of CD4+ and CD8+ T cells resulted in diminished chlamydia-specific delayed-type hypersensitivity responses, but antichlamydial antibody responses were unaffected. Our data indicate that immunity to chlamydial genital tract reinfection does not rely solely upon immune CD4+ or CD8+ T cells and further substantiate a predominant role for additional effector immune responses, such as B cells, in resistance to chlamydial genital tract reinfection.