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IEEE Transactions on Neural Systems and... Jul 2020Benchmarks have long been used to verify and compare the readiness level of different technologies in many application domains. In the field of wearable robots, the lack...
Benchmarks have long been used to verify and compare the readiness level of different technologies in many application domains. In the field of wearable robots, the lack of a recognized benchmarking methodology is one important impediment that may hamper the efficient translation of research prototypes into actual products. At the same time, an exponentially growing number of research studies are addressing the problem of quantifying the performance of robotic exoskeletons, resulting in a rich and highly heterogeneous picture of methods, variables and protocols. This review aims to organize this information, and identify the most promising performance indicators that can be converted into practical benchmarks. We focus our analysis on lower limb functions, including a wide spectrum of motor skills and performance indicators. We found that, in general, the evaluation of lower limb exoskeletons is still largely focused on straight walking, with poor coverage of most of the basic motor skills that make up the activities of daily life. Our analysis also reveals a clear bias towards generic kinematics and kinetic indicators, in spite of the metrics of human-robot interaction. Based on these results, we identify and discuss a number of promising research directions that may help the community to attain a comprehensive benchmarking methodology for robot-assisted locomotion more efficiently.
Topics: Biomechanical Phenomena; Exoskeleton Device; Humans; Locomotion; Lower Extremity; Walking
PubMed: 32634096
DOI: 10.1109/TNSRE.2020.2989481 -
International Journal of Developmental... Dec 2022The aim of this systematic review was to explore and discuss the literature concerning the effects of hypoxia or anoxia during the perinatal period on the serotoninergic...
PURPOSE
The aim of this systematic review was to explore and discuss the literature concerning the effects of hypoxia or anoxia during the perinatal period on the serotoninergic network in rodents, through mechanisms that lead to changes in serotonergic neurons, levels, segments of central nervous system affected, 5-HT transporter, and 5-HT receptor.
METHODS
Literature searches were performed in Embase, Medline (PubMed), Web of Science, and SCOPUS, from April to July 2021, with a total of 1045 published studies found. Using a predefined protocol, as registered on the CAMARADES website, 10 articles were included in this review. The PRISMA statement was used for reporting this systematic review. The internal validity was assessed using the SYRCLE's risk of bias tool.
RESULTS
Our main findings show that hypoxia in the first days of postnatal life led to a disturbance in the serotonergic system with reduced in 5-HT fibers, reduced brain levels of 5-HT and 5-HIAA, reduced SERT protein expression, and reduced receptor 5-HT . Putative mechanisms involving damage in the serotoninergic system include retrograde cell death resulting from primary damage mainly in forebrain areas, which impairs remote areas including serotonergic raphe nuclei. Other probable mechanisms associated with the serotoninergic network damage may be triggered by excitotoxic lesion and neuroinflammation.
CONCLUSION
Hypoxia at the beginning of an animal's life leads to modification of the serotonergic components associated with putative mechanisms that include cell damage and neuroinflammation.
Topics: Animals; Hypoxia; Models, Theoretical; Raphe Nuclei; Serotonergic Neurons; Serotonin
PubMed: 35996828
DOI: 10.1002/jdn.10226 -
Frontiers in Neurology 2023Increasing neuroimaging studies have revealed gray matter (GM) and white matter (WM) anomalies of several brain regions by voxel-based morphometry (VBM) studies on...
PURPOSE
Increasing neuroimaging studies have revealed gray matter (GM) and white matter (WM) anomalies of several brain regions by voxel-based morphometry (VBM) studies on patients with spinocerebellar ataxia type 3 (SCA3); however, the findings of previous studies on SCA3 patients by VBM studies remain inconsistent. The study aimed to identify consistent findings of gray matter (GM) and white matter (WM) changes in SCA3 patients by voxel-wise meta-analysis of whole-brain VBM studies.
METHODS
VBM studies comparing GM or WM changes in SCA3 patients and healthy controls (HCs) were retrieved from PubMed, Embase, Web of Science, and Medline databases from January 1990 to February 2023. Manual searches were also conducted, and authors of studies were contacted for additional data. The coordinates with significant differences in GM and WM between SCA3 patients and HCs were extracted from each cluster. A meta-analysis was performed using anisotropic effect size-based signed differential mapping (AES-SDM) software.
RESULTS
A total of seven studies comprising 160 SCA3 patients and 165 HCs were included in the GM volume meta-analysis. Three studies comprising 57 SCA3 patients and 63 HCs were included for WM volume meta-analysis. Compared with HC subjects, the reduced GM volume in SCA3 patients was found in the bilateral cerebellar hemispheres, cerebellar vermis, pons, right lingual gyrus, and right fusiform gyrus. The decreased WM volume was mainly concentrated in the bilateral cerebellar hemispheres, right corticospinal tract, middle cerebellar peduncles, cerebellar vermis, and left lingual gyrus. No increased density or volume of any brain structures was found. In the jackknife sensitivity analysis, the results remained largely robust.
CONCLUSION
Our meta-analysis clearly found the shrinkage of GM and WM volume in patients with SCA3. These lesions are involved in ataxia symptoms, abnormal eye movements, visual impairment, cognitive impairment, and affective disorders. The findings can explain the clinical manifestations and provide a morphological basis for SCA3.
PubMed: 37576018
DOI: 10.3389/fneur.2023.1197822 -
PloS One 2015Reports of outbreaks in Canada and the United States (U.S.) indicate that approximately 50% of all waterborne diseases occur in small non-community drinking water... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Reports of outbreaks in Canada and the United States (U.S.) indicate that approximately 50% of all waterborne diseases occur in small non-community drinking water systems (SDWSs). Summarizing these investigations to identify the factors and conditions contributing to outbreaks is needed in order to help prevent future outbreaks.
OBJECTIVES
The objectives of this study were to: 1) identify published reports of waterborne disease outbreaks involving SDWSs in Canada and the U.S. since 1970; 2) summarize reported factors contributing to outbreaks, including water system characteristics and events surrounding the outbreaks; and 3) identify terminology used to describe SDWSs in outbreak reports.
METHODS
Three electronic databases and grey literature sources were searched for outbreak reports involving SDWSs throughout Canada and the U.S. from 1970 to 2014. Two reviewers independently screened and extracted data related to water system characteristics and outbreak events. The data were analyzed descriptively with 'outbreak' as the unit of analysis.
RESULTS
From a total of 1,995 citations, we identified 50 relevant articles reporting 293 unique outbreaks. Failure of an existing water treatment system (22.7%) and lack of water treatment (20.2%) were the leading causes of waterborne outbreaks in SDWSs. A seasonal trend was observed with 51% of outbreaks occurring in summer months (p<0.001). There was large variation in terminology used to describe SDWSs, and a large number of variables were not reported, including water source and whether water treatment was used (missing in 31% and 66% of reports, respectively).
CONCLUSIONS
More consistent reporting and descriptions of SDWSs in future outbreak reports are needed to understand the epidemiology of these outbreaks and to inform the development of targeted interventions for SDWSs. Additional monitoring of water systems that are used on a seasonal or infrequent basis would be worthwhile to inform future protection efforts.
Topics: Canada; Disease Outbreaks; Drinking Water; Humans; United States; Water Microbiology; Water Supply; Waterborne Diseases
PubMed: 26513152
DOI: 10.1371/journal.pone.0141646 -
Children (Basel, Switzerland) Feb 2024(1) Aim: The aim of this study was to determine the relationship between lower limb bone deformities and body functions, activity, and participation in ambulant children... (Review)
Review
Bone Deformities through the Prism of the International Classification of Functioning, Disability and Health in Ambulant Children with Cerebral Palsy: A Systematic Review.
(1) Aim: The aim of this study was to determine the relationship between lower limb bone deformities and body functions, activity, and participation in ambulant children with CP and whether changing bone morphology affects outcomes in these domains. (2) Methods: A systematic literature search (PROSPERO CRD42020208416) of studies reporting correlations between measures of lower limb bone deformities and measures of body function, activity or participation, or post-surgical outcomes in these domains was conducted from 1990 to 2023 in Medline, Scopus, and Cochrane Library. We assessed study quality with the Checklist for Case Series (CCS) and a quality assessment developed by Quebec University Hospital. Meta-analysis was not possible; therefore, descriptive synthesis was performed. (3) Results: A total of 12 of 3373 screened articles were included. No studies evaluated the relationships between bone deformities and activity or participation, or the effect of isolated bone surgery on these domains. Correlations between bone deformities and body functions were poor-to-moderate. Internal hip rotation during gait improved after femoral derotation osteotomy. (4) Conclusions: A shift in paradigm is urgently required for the research and management of bone deformities in children with CP to include the activity and participation domains of the ICF, as well as consider more psychological aspects such as self-image.
PubMed: 38397369
DOI: 10.3390/children11020257 -
PloS One 2018The aim of this study was to report the metrological qualities of techniques currently used to quantify skeletal muscle volume and 3D shape in healthy and pathological...
AIMS
The aim of this study was to report the metrological qualities of techniques currently used to quantify skeletal muscle volume and 3D shape in healthy and pathological muscles.
METHODS
A systematic review was conducted (Prospero CRD42018082708). PubMed, Web of Science, Cochrane and Scopus databases were searched using relevant keywords and inclusion/exclusion criteria. The quality of the articles was evaluated using a customized scale.
RESULTS
Thirty articles were included, 6 of which included pathological muscles. Most evaluated lower limb muscles. Partially or completely automatic and manual techniques were assessed in 10 and 24 articles, respectively. Manual slice-by-slice segmentation reliability was good-to-excellent (n = 8 articles) and validity against dissection was moderate to good(n = 1). Manual slice-by-slice segmentation was used as a gold-standard method in the other articles. Reduction of the number of manually segmented slices (n = 6) provided good to excellent validity if a sufficient number of appropriate slices was chosen. Segmentation on one slice (n = 11) increased volume errors. The Deformation of a Parametric Specific Object (DPSO) method (n = 5) decreased the number of manually-segmented slices required for any chosen level of error. Other automatic techniques combined with different statistical shape or atlas/images-based methods (n = 4) had good validity. Some particularities were highlighted for specific muscles. Except for manual slice by slice segmentation, reliability has rarely been reported.
CONCLUSIONS
The results of this systematic review help the choice of appropriate segmentation techniques, according to the purpose of the measurement. In healthy populations, techniques that greatly simplified the process of manual segmentation yielded greater errors in volume and shape estimations. Reduction of the number of manually segmented slices was possible with appropriately chosen segmented slices or with DPSO. Other automatic techniques showed promise, but data were insufficient for their validation. More data on the metrological quality of techniques used in the cases of muscle pathology are required.
Topics: Humans; Magnetic Resonance Imaging; Muscle, Skeletal; Organ Size; Reproducibility of Results
PubMed: 30496308
DOI: 10.1371/journal.pone.0207847 -
Clinical Rehabilitation Sep 2018To determine the effects of ankle-foot orthoses (AFOs) on gait, balance, gross motor function and activities of daily living in children with cerebral palsy. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To determine the effects of ankle-foot orthoses (AFOs) on gait, balance, gross motor function and activities of daily living in children with cerebral palsy.
DATA SOURCES
Five databases were searched (Pubmed, Psycinfo, Web of Science, Academic Search Premier and Cochrane Library) before January 2018.
REVIEW METHODS
Studies of the effect of AFOs on gait, balance, gross motor function and activities of daily living in children with cerebral palsy were included. Articles with a modified PEDRO score ≥ 5/9 were selected. Data regarding population, AFO, interventions and outcomes were extracted. When possible, standardized mean differences (SMDs) were calculated from the outcomes.
RESULTS
Thirty-two articles, corresponding to 56 studies (884 children) were included. Fifty-one studies included children with spastic cerebral palsy. AFOs increased stride length (SMD = 0.88, P < 0.001) and gait speed (SMD = 0.28, P < 0.001), and decreased cadence (SMD = -0.72, P < 0.001). Gross motor function scores improved (Gross Motor Function Measure (GMFM) D (SMD = 0.30, P = 0.004), E (SMD = 0.28, P = 0.02), Pediatric Evaluation of Disability Inventory (PEDI) (SMD = 0.57, P < 0.001)). Data relating to balance and activities of daily living were insufficient to conclude. Posterior AFOs (solid, hinged, supra-malleolar, dynamic) increased ankle dorsiflexion at initial contact (SMD = 1.65, P < 0.001) and during swing (SMD = 1.34, P < 0.001), and decreased ankle power generation in stance (SMD = -0.72, P < 0.001) in children with equinus gait.
CONCLUSION
In children with spastic cerebral palsy, there is strong evidence that AFOs induce small improvements in gait speed and moderate evidence that AFOs have a small to moderate effect on gross motor function. In children with equinus gait, there is strong evidence that posterior AFOs induce large changes in distal kinematics.
Topics: Cerebral Palsy; Child; Foot Orthoses; Gait Disorders, Neurologic; Humans; Postural Balance; Walking Speed
PubMed: 29714066
DOI: 10.1177/0269215518771824 -
European Heart Journal. Acute... Oct 2021To help improving quality of care in patients with acute myocardial infarction (AMI), the European Society of Cardiology (ESC) set 20 quality indicators (QIs). There is...
AIMS
To help improving quality of care in patients with acute myocardial infarction (AMI), the European Society of Cardiology (ESC) set 20 quality indicators (QIs). There is a need to compile and summarize QI availability, feasibility, and global compliance in real-world registries.
METHODS AND RESULTS
A systematic review of PubMed and Web of Science was conducted including all original articles reporting the use of the ESC QIs in AMI patients. Methods and reporting follow the guidelines of the PRISMA Statement and the protocol was registered in PROSPERO (CRD42020190541). Among the 220 screened citations, 9 studies met the inclusion criteria after full-text review. Among these 9 studies, there were 11 different cohorts. Patients were recruited from three different continents (31 countries). The number of QIs assessed ranged from 6 to 20, with 5 studies (56%) reporting data for at least 75% of the 20 QIs. There were room for improvement in terms of data availability (i.e. domain 6 measuring patient's satisfaction), feasibility (i.e. difficulties to find all data for composite QIs in domain 7), and attainment (i.e. high levels of compliance with the percentage of reperfused ST-segment elevation myocardial infarction patients, but low levels for a timely reperfusion).
CONCLUSIONS
Our systematic review has shown that it is possible to measure most QIs in existing registries, and that there is room for improvement in terms of data availability, feasibility, and levels of attainment to QIs. Our findings may influence the design of future registries to capture this information and help in QIs definition updates.
Topics: Cardiology; Humans; Myocardial Infarction; Quality Indicators, Health Care; Registries; ST Elevation Myocardial Infarction
PubMed: 34151368
DOI: 10.1093/ehjacc/zuab042 -
Systematic Reviews Jun 2020Vestibular compensation is a homeostatic process that occurs in the central nervous system in response to peripheral vestibular dysfunction. Experimental studies in... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Vestibular compensation is a homeostatic process that occurs in the central nervous system in response to peripheral vestibular dysfunction. Experimental studies in rodent models have suggested that unilateral peripheral vestibular lesions are correlated with an increase in the intrinsic excitability of central vestibular neurons. This process may be dependent on the intrinsic properties of the neurons themselves. We aimed to conduct a systematic review of the literature to survey the evidence for changes in intrinsic plasticity observed during the acute phase of vestibular compensation.
METHODS
We systematically reviewed the literature regarding the electrophysiological effect of experimentally induced unilateral vestibular deafferentation (UVD) on the intrinsic membrane properties of medial vestibular nucleus neurons in animal models. We developed tools to assess the methodological quality (precision, validity and bias) of studies that met pre-determined inclusion and exclusion criteria. We extracted numerical data and performed a meta-analysis of specific quantitative data pooled from these studies.
RESULTS
We identified 17 studies that satisfied the inclusion criteria. There is moderate quality evidence to suggest a statistically significant increase in the intrinsic excitability of medial vestibular nucleus neurons following unilateral vestibular deafferentation. Specifically, the spontaneous discharge rate increases by 4 spikes/s on average and the sensitivity to current stimuli increases.
CONCLUSION
Using this novel approach, we demonstrate that the methodology of systematic review and meta-analysis is a useful tool in the summation of data across experimental animal studies with similar aims.
Topics: Animals; Denervation; Neuronal Plasticity; Neurons; Vestibular Nuclei
PubMed: 32552855
DOI: 10.1186/s13643-020-01399-2 -
Orthopaedics & Traumatology, Surgery &... May 2023Rectus femoris (RF) transfer was long the gold-standard treatment for stiff knee gait (SKG), but efficacy now seems less than that of distal RF release. The aim of the... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Rectus femoris (RF) transfer was long the gold-standard treatment for stiff knee gait (SKG), but efficacy now seems less than that of distal RF release. The aim of the present study was to compare efficacy between the two. The study hypothesis was that both significantly improve 4 knee kinematic parameters at 1 year.
PATIENTS AND METHOD
A meta-analysis was performed, using PRISMA criteria, on the Medline, Science Direct, Cochrane Registry, Scopus and Pascal databases. Search was conducted up to March 1, 2020 by two authors (A.J & M.T). Study methodology was assessed on MINORS index. Inclusion criteria comprised patients with SKG, treated by RF transfer or distal release. Endpoints comprised: Peak Knee Flexion in swing phase (PKF), Knee Range of Motion (KROM), time to Peak Knee Flexion (t-PKF), and Maximum Knee Extension in stance phase (MKE). Effect size was assessed on Standard Mean Deviation (SMD).
RESULTS
A total of 695 studies were identified, 16 of which were included: 14 transfer, 5 release. Data were analyzed for 1,079 limbs in 768 patients. Only transfer improved PKF, with small effect size (SMD=0.29). The other three parameters were improved by both techniques, with moderate effect size.
DISCUSSION
Results showed improved knee kinematics after RF transfer, but with small or moderate effect size. The effect of distal release on PKF could not be assessed, due to publication bias. The heterogeneity of studies and low levels of evidence call for caution in interpreting the present results.
LEVEL OF EVIDENCE
III.
Topics: Humans; Biomechanical Phenomena; Cerebral Palsy; Gait; Gait Disorders, Neurologic; Knee; Knee Joint; Quadriceps Muscle; Range of Motion, Articular; Treatment Outcome
PubMed: 34314902
DOI: 10.1016/j.otsr.2021.103022