Ground reaction forces during stair ascending and descending in congenitally blind and sighted individuals

BackgroundStair ascending and descending are common in daily life activities which are challenging for blind individuals. Visual information plays an important role in controlling an individual's movements. However, the relationship between visual information and stair ascending and descending is poorly understood.ObjectiveThe aim of this study was to investigate how blindness alters the ground reaction force (GRF) components during ascending and descending the stairs.MethodsTen individuals with congenital blindness and 10 able-bodied sighted individuals were served as experimental (EG) and control groups (CG), respectively. The GRFs were recorded during stair ascending and descending tasks using a portable 40 × 40 cm Kistler force plate which was placed on a firm stair. CG repeated the ascending/descending tasks in both open and closed-eyes conditions. For within and between groups comparisons the repeated measure ANOVA and MANOVA tests were used, respectively. The significance level was set at p < 0.05 for all comparisons.ResultsIn ascending task, there was not any significant between group differences on GRF components. However, closing the eyes in CG resulted in a significant decrease in some GRF components in the stair descending (p < 0.05). The GRF components of the stair descending in CG with open and closed-eyes were significantly different from those in the blind group; however, the differences were less in closed-eyes.SignificanceThe GRF in the stair descent was similar in both blind and sighted individuals with closed-eyes condition, that it can increase the risk of falling in blind people. As a result, the provision of tools and equipment for the blind in descent conditions is essential.     

Reliable detection of bilateral activation in human primary somatosensory cortex by unilateral median nerve stimulation

In non-human primates, a bilateral representation of unilaterally presented somatosensory information can be found at the lowest level of cortical processing as indicated by the presence of neurons with bilateral receptive fields in the hand region of primary somatosensory (SI) cortex. In humans, such bilateral activation of SI is considered controversial due to highly variable detection rates for the much weaker ipsilateral response across different studies (ranging from 3% to 100%). Second-order blind identification (SOBI) is a blind source separation algorithm that has been successfully used to isolate neuronal signals from functionally distinct brain regions, including the left- and right-SI. SOBI-aided extraction of left- and right-SI responses to median nerve stimulation from high-density EEG has been previously validated against the fMRI and MEG literature. Here, we applied SOBI to EEG data and examined whether relatively weaker ipsilateral activations could be reliably detected across subjects. In single subject analysis, statistically significant somatosensory evoked potentials (SEPs) in response to unilateral stimulation were detected from both SI contralateral to and SI ipsilateral to the side of stimulation. Furthermore, these ipsilateral responses were observed in both the left and right hemispheres of all 10 subjects studied. Together these results demonstrate that unilateral stimulation of the median nerve, whether applied to the left or right wrist, can activate both the left- and right-SI, raising the possibility that in humans, unilateral sensory input may be bilaterally represented at the lowest level of cortical processing.     

Comparison of the Macintosh laryngoscope and blind intubation via the iGEL for Intubation With C-spine immobilization: A Randomized,crossover, manikin trial

Introduction

Endotracheal intubation (ETI) using a Macintosh laryngoscope (MAC) requires the head to be positioned in a modified Jackson position, slightly reclined and elevated. Intubation of trauma patients with an injured neck or spine is therefore difficult, since the neck usually cannot be turned or is already immobilized in order to prevent further injury. The iGEL supraglottic airway seems optimal for such conditions due to its blind insertion without the need of a modified Jackson position.

一次性负压引流器用于肛管排气的效果观察

将一次性负压引流器用于２１例各类腹部手术后肠胀气病人，并与行肛管排气的１５例病人进行排气效果比较。结果显示：腹胀即刻缓解率一次性负压引流器组２０例，常规肛管排气组５例，经χ２检验有显著性差异（Ｐ＜０．０１）。提示一次性负压引流器排气效果优于肛管排气     

Role of blind closed pleural biopsy in the management of pleural exudates

INTRODUCTION:

The performance of blind closed pleural biopsy (BCPB) in the study of pleural exudates is controversial.

OBJECTIVE:

To assess the diagnostic yield of BCPB in clinical practice and its role in the study of pleural exudates.

METHODS:

Data were retrospectively collected on all patients who underwent BCPB performed between January 1999 and December 2011.

RESULTS:

A total of 658 BCPBs were performed on 575 patients. Pleural tissue was obtained in 590 (89.7%) of the biopsies. A malignant pleural effusion was found in 35% of patients. The cytology and the BCPB were positive in 69.2% and 59.2% of the patients, respectively. Of the patients with negative cytology, 21 had a positive BCPB (diagnostic improvement, 15%), which would have avoided one pleuroscopy for every seven BCPBs that were performed. Of the 113 patients with a tuberculous effusion, granulomas were observed in 87 and the Lowenstein culture was positive in an additional 17 (sensitivity 92%). The overall sensitivity was 33.9%, with a specificity and positive predictive value of 100%, and a negative predictive value of 71%. Complications were recorded in 14.4% of patients (pneumothorax 9.4%; chest pain 5.6%; vasovagal reaction, 4.1%; biopsy of another organ 0.5%).

CONCLUSIONS:

BCPB still has a significant role in the study of a pleural exudate. If an image-guided technique is unavailable, it seems reasonable to perform BCPB before resorting to a pleuroscopy. These results support BCPB as a relatively safe technique.     

An extended exploratory projection pursuit network with linear and nonlinear anti-hebbian lateral connections applied to the cocktail party problem

We propose a novel nonlinear self-organising network, which employs hebbian and anti-hebbian learning, in approximating a linear independent component analysis. We use nonlinear activation functions, which can deal with mixtures of platykurtic or leptokurtic data distributions. The learning algorithms diagonalise the input data covariance matrix, then perform an orthogonal rotation which approximates maximisation of the sum of squares of fourth order marginal cumulant, thus providing separation of the input into the individual independent subcomponens. We apply this network to linear mixtures of natural speech data, which are inherently non-stationary and positively kurtotic. Simulations are run on linear mixtures of five speakers and rapid convergence and complete source separation is shown.     

Efficacy and Influence on Quality of Life of Enalapril as a First Step Treatment of Hypertension

205 patients with mild to moderate uncomplicated hypertension participated in a six-month double-blind parallel study performed in a unique center. After a two-week single-blind placebo period, the patients were randomly allocated to receive either Enalapril 20 mg once-a-day or placebo as the first step treatment. They were then followed-up every two weeks and successive doses of hydrochlorothiazide, oxprenolol, and dihydralazine were added until the diastolic pressure was lower than 90 mmHg. After six months, the systolic and diastolic blood pressures were lower in the Enalapril than in the control group (129/82+12/6 mmHg versus 136/86 ± 10/5 mmHg; p < 0.001). Drug withdrawal was necessary for 8 patients in the Enalapril group and for 16 patients in the control group (p < 0.05). The number of daily tablets was 2.7+1.8 in the Enalapril group and 4.4±2.4 in the control group (p < 0.01). Therefore, a stepped-care program based on Enalapril appears significantly more effective than a stepped-care program based on a diuretic.     

Diabetic Retinopathy as a Cause of Blindness in the Province of Turin,North-west Italy,in 1967–1991

Diabetes is known to be a major contributor to blindness in industrialized countries but few data are available on the situation in Italy. As an introductory step to the implementation of permanent screening for diabetic retinopathy, a search was carried out on the causes of visual loss in the provincial territory surrounding Turin, the main city of North-West Italy. The case notes of all 4549 residents in the province who were certified blind between 1967 and 1991 were examined with regard to cause, age at onset, and year of onset of visual acuity 1/20. Diabetic retinopathy was the second commonest cause of bilateral blindness (13.1 % of cases), preceded by cataract (26.7%) and followed by myopia (11.1%), optic atrophy (8.9%), glaucoma (8.9%), retinitis pigmentosa (7.2%), and senile macular degeneration (4.1%). Diabetic retinopathy was the commonest eye disease among those who became blind between the ages of 50 and 70 and remained the leading cause of visual loss when the age groups 20 to 70 were pooled together. The incidence of diabetic retinopathy-related blindness did not show any trend to decrease over the 25 years investigated. It is concluded that, in spite of widespread availability of facilities for its assessment and treatment, diabetic retinopathy remains a leading cause of blindness in North-West Italy. This fully justifies the implementation of screening programmes and efficient referral chains for the early detection and prompt treatment of this complication of diabetes.     

超声引导与盲穿法肾活检术在临床中的应用分析

目的探讨比较超声引导下经皮肾活检术与超声定位后经皮盲穿法肾活检术在临床应用中的优越性。方法将我院肾脏内科收治的100例肾脏病患者,在彩超引导下行肾活检术,分成A组;同期广元市医院收治的100例肾脏病患者,在彩超定位后使用＂十＂字盲穿法行肾活检术,分成B组。观察分析两组其成功率及并发症。结果 A组患者一针成功取材92例,二针成功取材96例,成功率分别为92%、96%;B组一针成功取材63例,二针成功取材82例,失败2例,成功率分别为63%、82%。A组并发症发生率6%;B组并发症发生率23%。结论用BARD MAGNUM自动穿刺枪经皮超声引导下行肾活检术相比超声定位后经皮盲穿法肾活检术并发症少,风险小,成功率高。