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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 -
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 -
Neurosurgical Review Apr 2021Brainstem hemangioblastomas are benign, highly vascular tumors located in the mesencephalon, pons, and medulla oblongata. Although surgical resection is currently... (Meta-Analysis)
Meta-Analysis
Brainstem hemangioblastomas are benign, highly vascular tumors located in the mesencephalon, pons, and medulla oblongata. Although surgical resection is currently considered the main therapeutic option for symptomatic lesions, evidence supporting the application of microsurgery has not been systematically assessed. This meta-analysis aims to evaluate the safety and efficacy of surgical treatment for brainstem hemangioblastomas. A comprehensive search of the PubMed, Embase, and Web of Science databases was performed to identify all English language publications reporting the outcomes of surgical treatment for brainstem hemangioblastomas. Studies from January 1990 to July 2019 with ≥ 10 cases were included. We analyzed the surgical outcomes, including gross total resection, mortality, neurological morbidity, and functional outcome according to the McCormick Scale or Karnofsky Performance Scale. Thirteen studies with 473 cases were included. The pooled proportion of gross total resection was 98% (95% confidence interval (CI), 94-100%). Overall mortality and neurological morbidity were 4 (95% CI, 2-6%) and 13% (95% CI, 7-20%), respectively. Favorable functional outcomes at the last follow-up were achieved in 85% (95% CI, 78-92%) of all patients. Improved or stable functional outcomes at long-term follow-up were achieved in 94% (95% CI, 89-97%) of patients. This meta-analysis revealed that surgical treatment for brainstem hemangioblastomas is technically feasible and effective with lasting patient benefits and cure.
Topics: Adult; Brain Stem Neoplasms; Female; Hemangioblastoma; Humans; Karnofsky Performance Status; Male; Microsurgery; Middle Aged; Neurosurgical Procedures; Observational Studies as Topic; Retrospective Studies; Treatment Outcome
PubMed: 32356022
DOI: 10.1007/s10143-020-01305-3 -
Neurology Jan 2020To assess the evidence of a relationship between muscle MRI and disease severity in Duchenne muscular dystrophy (DMD).
OBJECTIVE
To assess the evidence of a relationship between muscle MRI and disease severity in Duchenne muscular dystrophy (DMD).
METHODS
We conducted a systematic review of studies that analyzed correlations between MRI measurements and motor function in patients with DMD. PubMed, Cochrane, Scopus, and Web of Science were searched using relevant keywords and inclusion/exclusion criteria (January 1, 1990-January 31, 2019). We evaluated article quality using the Joanna Briggs Institute scale. Information regarding the samples included, muscles evaluated, MRI protocols and motor function tests used was collected from each article. Correlations between MRI measurements and motor function were reported exhaustively.
RESULTS
Seventeen of 1,629 studies identified were included. Most patients included were ambulant with a mean age of 8.9 years. Most studies evaluated lower limb muscles. Moderate to excellent correlations were found between MRI measurements and motor function. The strongest correlations were found for quantitative MRI measurements such as fat fraction or mean T2. Correlations were stronger for lower leg muscles such as soleus. One longitudinal study reported that changes in soleus mean T2 were highly correlated with changes in motor function.
CONCLUSION
The findings of this systematic review showed that MRI measurements can be used as biomarkers of disease severity in ambulant patients with DMD. Guidelines are proposed to help clinicians choose the most appropriate MRI measurements and muscles to evaluate. Studies exploring upper limb muscles, other stages of the disease, and sensitivity of measurements to change are needed.
Topics: Humans; Magnetic Resonance Imaging; Male; Motor Activity; Muscle, Skeletal; Muscular Dystrophy, Duchenne
PubMed: 31892637
DOI: 10.1212/WNL.0000000000008811 -
Archives of Gynecology and Obstetrics Oct 2019Uterine angioleiomyoma is a rare type of leiomyoma variant and there are few cases reported in the literature. The definitive diagnosis is usually obtained only after...
PURPOSE
Uterine angioleiomyoma is a rare type of leiomyoma variant and there are few cases reported in the literature. The definitive diagnosis is usually obtained only after the histopathologic examination because there are no specific imaging criteria for this disease. The objective of this article is to review published cases about this clinical condition.
METHODS
We report a case of giant angioleiomyoma superinfected by S. agalactiae with the development of latero-cervical distant metastasis in a premenopausal woman. Firstly, the case herein reported was orientated as an endometrial stroma sarcoma in the peri-operative histologic examination by frozen sections. It was treated with laparotomic total hysterectomy, bilateral salpingo-oophorectomy, inframesocolic omentectomy and pelvic and paraaortic lymph node dissection. Postoperative definitive anatomopathological analyses using a proper immunohistochemical panel revealed a case of uterine angioleiomyoma. We also review other case reports published about this clinical condition.
RESULTS
We present the first case reported in the literature, in our knowledge, of a giant angioleiomyoma superinfected by S. agalactiae with the development of distant septic metastases. Immunohistochemistry permitted the definitive diagnosis of angioleiomyoma. Treatments previously reported are hysterectomy or tumor resection and any patient recurred.
CONCLUSIONS
The definitive diagnosis is usually obtained after the definitive histopathologic examination since the use of immunohistochemical study has an important role in this regard. Complete surgical removal of the lesion is the treatment of choice, with no recurrent cases reported to date.
Topics: Angiomyoma; Female; Humans; Middle Aged; Neoplasm Metastasis; Neoplasms; Sepsis; Uterine Neoplasms
PubMed: 31435775
DOI: 10.1007/s00404-019-05267-w -
Journal of Clinical Neuroscience :... Aug 2019We studied patients with chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) associated with or without lymphoma and...
Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) associated with or without lymphoma: Comparison of clinical features and risk factors suggestive of underlying lymphomas.
BACKGROUND
We studied patients with chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) associated with or without lymphoma and measured risk factors suggestive of an underlying lymphoma and follow-up outcomes.
METHODS
CLIPPERS patients associated with or without lymphoma were included into this study. Clinical presentations were documented, risk factors suggestive of an underlying lymphoma were tested, and prognostic differences in terms of death were compared.
RESULTS
Ten patients had a diagnosis of CLIPPERS associated with lymphoma, with 6 B-cell non-Hodgkin lymphoma, 2 T-cell non-Hodgkin lymphoma and 2 Hodgkin lymphoma. Using multivariate logistic analysis, the following 3 independent risk factors were found to be related to a final diagnosis of lymphoma: hyperreflexia (HR 16.56; 95% CI 1.03-265.29; p = 0.032), elevated protein in CSF (HR 11.59; 95% CI 1.24-108.39; p = 0.047), and recurrences between 2 months and 1 year after treatment (HR 29.27; 95% CI 2.09-409.58; p = 0.012). The model calibration was satisfactory (p = 0.392 with the Hosmer-Lemeshow test), and the discrimination power was good (area under the receiver operating characteristic curve 0.921; p < 0.001, 95% CI 0.826-1.000). Patients with CLIPPERS associated with lymphoma had higher mortality rate and lymphoma was a significant predictor of total mortality (HR 0.040; 95% CI 0.006-0.262; p = 0.001).
CONCLUSIONS
Hyperreflexia, elevated protein in CSF and recurrences between 2 months and 1 year after treatment are risk factors suggesting an underlying lymphoma. Relapses during high-dose steroids maintenance therapy can be indicative of lymphoma, too. Patients having CLIPPERS associated with lymphoma have a worse prognosis than those without lymphoma.
Topics: Adult; Brain Diseases; Female; Humans; Inflammation; Lymphoma; Magnetic Resonance Imaging; Male; Middle Aged; Pons; Steroids
PubMed: 31088767
DOI: 10.1016/j.jocn.2019.04.022