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Abstract Predicting the blood–brain barrier (BBB) permeability of small-molecule compounds using a novel artificial intelligence platform is necessary for drug discovery. Machine learning and a large language model on artificial intelligence (AI) tools improve the accuracy and shorten the time for new drug development. The primary goal of this research is to develop artificial intelligence (AI) computing models and novel deep learning architectures capable of predicting whether molecules can permeate the human blood–brain barrier (BBB). The in silico (computational) and in vitro (experimental) results were validated by the Natural Products Research Laboratories (NPRL) at China Medical University Hospital (CMUH). The transformer-based MegaMolBART was used as the simplified molecular input line entry system (SMILES) encoder with an XGBoost classifier as an in silico method to check if a molecule could cross through the BBB. We used Morgan or Circular fingerprints to apply the Morgan algorithm to a set of atomic invariants as a baseline encoder also with an XGBoost classifier to compare the results. BBB permeability was assessed in vitro using three-dimensional (3D) human BBB spheroids (human brain microvascular endothelial cells, brain vascular pericytes, and astrocytes). Using multiple BBB databases, the results of the final in silico transformer and XGBoost model achieved an area under the receiver operating characteristic curve of 0.88 on the held-out test dataset. Temozolomide (TMZ) and 21 randomly selected BBB permeable compounds (Pred scores = 1, indicating BBB-permeable) from the NPRL penetrated human BBB spheroid cells. No evidence suggests that ferulic acid or five BBB-impermeable compounds (Pred scores

Abstract The emergence of severe acute respiratory syndrome (SARS) underscored the importance of influenza detection and response in China. From 2004, the Chinese National Influenza Center (CNIC) and the United States Centers for Disease Control and Prevention (USCDC) initiated Cooperative Agreements to build capacity in influenza surveillance in China. From 2004 to 2014, CNIC and USCDC collaborated on the following activities: 1) developing human technical expertise in virology and epidemiology in China; 2) developing a comprehensive influenza surveillance system by enhancing influenza-like illness (ILI) reporting and virological characterization; 3) strengthening analysis, utilization and dissemination of surveillance data; and 4) improving early response to influenza viruses with pandemic potential. Since 2004, CNIC expanded its national influenza surveillance and response system which, as of 2014, included 408 laboratories and 554 sentinel hospitals. With support from USCDC, more than 2500 public health staff from China received virology and epidemiology training, enabling > 98% network laboratories to establish virus isolation and/or nucleic acid detection techniques. CNIC established viral drug resistance surveillance and platforms for gene sequencing, reverse genetics, serologic detection, and vaccine strains development. CNIC also built a bioinformatics platform to strengthen data analysis and utilization, publishing weekly on-line influenza surveillance reports in English and Chinese. The surveillance system collects 200,000–400,000 specimens and tests more than 20,000 influenza viruses annually, which provides valuable information for World Health Organization (WHO) influenza vaccine strain recommendations. In 2010, CNIC became the sixth WHO Collaborating Centre for Influenza. CNIC has strengthened virus and data sharing, and has provided training and reagents for other countries to improve global capacity for influenza control and prevention. The collaboration’s successes were built upon shared mission and values, emphasis on long-term capacity development and sustainability, and leadership commitment.

In this study, NO2 columns from the US EPA Models-3/CMAQ model simulations carried out using the 2001 ACE-ASIA (Asia Pacific Regional Aerosol Characterization Experiment) emission inventory over East Asia were compared with the GOME-derived NO2 columns. There were large discrepancies between the CMAQ-predicted and GOME-derived NO2 columns in the fall and winter seasons. In particular, while the CMAQ-predicted NO2 columns produced larger values than the GOME-derived NO2 columns over South Korea for all four seasons, the CMAQ-predicted NO2 columns produced smaller values than the GOME-derived NO2 columns over North China for all seasons with the exception of summer (summer anomaly). It is believed that there might be some error in the NOx emission estimates as well as uncertainty in the NOx chemical loss rates over North China and South Korea. Regarding the latter, this study further focused on the biogenic VOC (BVOC) emissions that were strongly coupled with NOx chemistry during summer in East Asia. This study also investigated whether the CMAQ-modeled NO2/NOx ratios with the possibly overestimated isoprene emissions were higher than those with reduced isoprene emissions. Although changes in both the NOx chemical loss rates and NO2/NOx ratios from CMAQ-modeling with the different isoprene emissions affected the CMAQ-modeled NO2 levels, the effects were found to be limited, mainly due to the low absolute levels of NO2 in summer. Seasonal variations of the NOx emission fluxes over East Asia were further investigated by a set of sensitivity runs of the CMAQ model. Although the results still exhibited the summer anomaly possibly due to the uncertainties in both NOx-related chemistry in the CMAQ model and the GOME measurements, it is believed that consideration of both the seasonal variations in NOx emissions and the correct BVOC emissions in East Asia are critical. Overall, it is estimated that the NOx emissions are underestimated by ~57.3% in North China and overestimated by ~46.1% in South Korea over an entire year. In order to confirm the uncertainty in NOx emissions, the NOx emissions over South Korea and China were further investigated using the ACE-ASIA, REAS (Regional Emission inventory in ASia), and CAPSS (Clean Air Policy Support System) emission inventories. The comparison between the CMAQ-calculated and GOME-derived NO2 columns indicated that both the ACE-ASIA and REAS inventories have some uncertainty in NOx emissions over North China and South Korea, which can also lead to some errors in modeling the formation of ozone and secondary aerosols in South Korea and North China.

This paper presents a novel numerical procedure based on the combination of an edge-based smoothed finite element (ES-FEM) with a phantom-node method for 2D linear elastic fracture mechanics. In the standard phantom-node method, the cracks are formulated by adding phantom nodes, and the cracked element is replaced by two new superimposed elements. This approach is quite simple to implement into existing explicit finite element programs. The shape functions associated with discontinuous elements are similar to those of the standard finite elements, which leads to certain simplification with implementing in the existing codes. The phantom-node method allows modeling discontinuities at an arbitrary location in the mesh. The ES-FEM model owns a close-to-exact stiffness that is much softer than lower-order finite element methods (FEM). Taking advantage of both the ES-FEM and the phantom-node method, we introduce an edge-based strain smoothing technique for the phantom-node method. Numerical results show that the proposed method achieves high accuracy compared with the extended finite element method (XFEM) and other reference solutions.

The structure and distribution of sub-glacial water directly influences Antarctic ice mass loss by reducing or enhancing basal shear stress and accelerating grounding line retreat. A common technique for detecting sub-glacial water involves analyzing the spatial variation in reflectivity from an airborne radar echo sounding (RES) survey. Basic RES analysis exploits the high dielectric contrast between water and most other substrate materials, where a reflectivity increase ≥ 15 dB is frequently correlated with the presence of sub-glacial water. There are surprisingly few additional tools to further characterize the size, shape, or extent of hydrological systems beneath large ice masses. We adapted an existing radar backscattering simulator to model RES reflections from sub-glacial water structures using the University of Texas Institute for Geophysics (UTIG) Multifrequency Airborne Radar Sounder with Full-phase Assessment (MARFA) instrument. Our series of hypothetical simulation cases modeled water structures from 5 to 50 m wide, surrounded by bed materials of varying roughness. We compared the relative reflectivity from rounded Röthlisberger channels and specular flat canals, showing both types of channels exhibit a positive correlation between size and reflectivity. Large (> 20 m), flat canals can increase reflectivity by more than 20 dB, while equivalent Röthlisberger channels show only modest reflectivity gains of 8–13 dB. Changes in substrate roughness may also alter observed reflectivity by 3–6 dB. All of these results indicate that a sophisticated approach to RES interpretation can be useful in constraining the size and shape of sub-glacial water features. However, a highly nuanced treatment of the geometric context is necessary. Finally, we compared simulated outputs to actual reflectivity from a single RES flight line collected over Thwaites Glacier in 2022. The flight line crosses a previously proposed Röthlisberger channel route, with an obvious bright bed reflection in the radargram. Through multiple simulations comparing various water system geometries, such as canals and sub-glacial lakes, we demonstrated the important role that topography and water geometry can play in observed RES reflectivity. From the scenarios that we tested, we concluded the bright reflector from our RES flight line cannot be a Röthlisberger channel but could be consistent with a series of flat canals or a sub-glacial lake. However, we note our simulations were not exhaustive of all possible sub-glacial water configurations. The approach outlined here has broad applicability for studying the basal environment of large glaciers. We expect to apply this technique when constraining the geometry and extent of many sub-glacial hydrologic structures in the future. Further research may also include comprehensive investigations of the impact of sub-glacial roughness, substrate heterogeneity, and computational efficiencies enabling more complex and complete simulations.

The recent commercial availability of stacked dielectric elastomer actuators (SDEAs) has unlocked new opportunities for their application as “artificial skeletal muscles” in rehabilitation robots and powered exoskeletons. Composed of multiple layers of thin, elastic capacitors, these actuators present a lightweight, soft, and acoustically noiseless alternative to traditional DC motor actuators commonly used in rehabilitation robotics, thereby enhancing the natural feel of such systems. Building on our previous research, this study aimed to evaluate the most recent version of commercial SDEAs to assess their potential for mechanizing rehabilitation robots. We quantified the stress and strain behavior and stiffness of these actuators in both single and 1 × 3 configurations (with three SDEAs connected in series). The actuators demonstrated the capability to generate up to 25 N of force and 115 KPa, a value surpassing human biceps, with a longitudinal strain measured at about 11%. The significant increase in force generation from 10 N in the previous version to 25 N and displacement from 3.3% to 11% substantially enhances the applicability of this actuator in rehabilitation robotics. SDEAs’ high force generation capability, combined with their strain and stress characteristics comparable to that of human biological muscles, make them ideal alternative actuators for biomimetic robots and applications where actuators must operate in the vicinity of the human body.

Conventional passive ankle foot orthoses (AFOs) have not seen substantial advances or functional improvements for decades, failing to meet the demands of many stakeholders, especially the pediatric population with neurological disorders. Our objective is to develop the first comfortable and unobtrusive powered AFO for children with cerebral palsy (CP), the DE-AFO. CP is the most diagnosed neuromotor disorder in the pediatric population. The standard of care for ankle control dysfunction associated with CP, however, is an unmechanized, bulky, and uncomfortable L-shaped conventional AFO. These passive orthoses constrain the ankle’s motion and often cause muscle disuse atrophy, skin damage, and adverse neural adaptations. While powered orthoses could enhance natural ankle motion, their reliance on bulky, noisy, and rigid actuators like DC motors limits their acceptability. Our innovation, the DE-AFO, emerged from insights gathered during customer discovery interviews with 185 stakeholders within the AFO ecosystem as part of the NSF I-Corps program. The DE-AFO is a biomimetic robot that employs artificial muscles made from an electro-active polymer called dielectric elastomers (DEs) to assist ankle movements in the sagittal planes. It incorporates a gait phase detection controller to synchronize the artificial muscles with natural gait cycles, mimicking the function of natural ankle muscles. This device is the first of its kind to utilize lightweight, compact, soft, and silent artificial muscles that contract longitudinally, addressing traditional actuated AFOs’ limitations by enhancing the orthosis’s natural feel, comfort, and acceptability. In this paper, we outline our design approach and describe the three main components of the DE-AFO: the artificial muscle technology, the finite state machine (the gait phase detection system), and its mechanical structure. To verify the feasibility of our design, we theoretically calculated if DE-AFO can provide the necessary ankle moment assistance for children with CP—aligning with moments observed in typically developing children. To this end, we calculated the ankle moment deficit in a child with CP when compared with the normative moment of seven typically developing children. Our results demonstrated that the DE-AFO can provide meaningful ankle moment assistance, providing up to 69% and 100% of the required assistive force during the pre-swing phase and swing period of gait, respectively.

Smoothness is a hallmark of skilled, coordinated movement, however, mathematically quantifying movement smoothness is nuanced. Several smoothness metrics exist, each having its own limitations and may be specific to a particular motion such as upper limb reaching. To date, there is no consensus on which smoothness metric is the most appropriate for assessing cycling motion in children with cerebral palsy (CP). We evaluated the ability of four preexisting metrics, dimensionless jerk, spectral arc length measure, roughness index, and cross-correlation; and two new metrics, arc length and root mean square error, to quantify the smoothness of cycling in a preexisting dataset from children with CP (mean age 13.7 ± 2.6 years). First, to measure the repeatability of each measure in distinguishing between different levels of un-smoothness, we applied each metric to a set of simulated crank motion signals with a known number of aberrant revolutions using subjects’ actual crank angle data. Second, we used discriminant function analysis to statistically compare the strength of the six metrics, relative to each other, to discriminate between a smooth cycling motion obtained from a dataset of typically developed children (TD), the control group (mean age 14.9 ± 1.4 years), and a less smooth, halted cycling motion obtained from children with CP. Our results show that (1) ArcL showed the highest repeatability in accurately quantifying an unsmooth motion when the same cycling revolutions were presented in a different order, and (2) ArcL and DJ had the highest discriminatory ability to differentiate between an unsmooth and smooth cycling motion. Combining the results from the repeatability and discriminatory analysis, ArcL was the most repeatable and sensitive metric in identifying unsmooth, halted cycling motion from smooth motion. ArcL can hence be used as a metric in future studies to quantify changes in the smoothness of cycling motion pre- vs. post-interventions. Further, this metric may serve as a tool to track motor recovery not just in individuals with CP but in other patient populations with similar neurological deficits that may present with halted, unsmooth cycling motion.

Hybrid ensemble-variational data assimilation (DA) methods have gained significant traction in recent years. These methods aim to alleviate the limitations and maximise the advantages offered by ensemble or variational methods. Most existing hybrid applications focus on the mid-latitudinal context; almost none have explored its benefits in the tropical context. In this article, hybrid ensemble-variational DA is introduced to a tropical configuration of a simplified non-hydrostatic convective-scale fluid dynamics model (the ABC model, named after its three key parameters: the pure gravity wave frequency A, the controller of the acoustic wave speed B, and the constant of proportionality between pressure and density perturbations C), and its existing variational framework, the ABC-DA system. The hybrid ensemble-variational DA algorithm is developed based on the alpha control variable approach, often used in numerical weather prediction. Aspects of the algorithm such as localisation (used to mitigate sampling error caused by finite ensemble sizes) and weighting parameters (used to weight the ensemble and climatological contributions to the background error covariance matrix) are implemented. To produce the flow-dependent error modes (ensemble perturbations) for the ensemble-variational DA algorithm, an ensemble system is also designed for the ABC model which is run alongside the hybrid DA system. A random field perturbations method is used to generate an initial ensemble which is then propagated using the ensemble bred vectors method. This setup allows the ensemble to be centred on the hybrid control analysis. Visualisation software has been developed to focus on the diagnosis of the ensemble system. To demonstrate the hybrid ensemble-variational DA in the ABC-DA system, sensitivity tests using observing system simulation experiments are conducted within a tropical framework. A 30-member ensemble was used to generate the error modes for the experiments. In general, the best performing configuration (with respect to the “truth”) for the hybrid ensemble-variational DA system used an 80%/20% weighting on the ensemble-derived/climatological background error covariance matrix contributions. For the horizontal wind variables though, full weight on the ensemble-derived background error covariance matrix (100%/0%) resulted in the smallest cycle-averaged analysis root mean square errors, mainly due to large errors in the meridional wind field when contributions from the climatological background error covariance matrix were involved, possibly related to a sub-optimal background error covariance model. The ensemble bred vectors method propagated a healthy-looking DA-centred ensemble without bimodalities or evidence of filter collapse. The ensemble was under-dispersive for some variables but for others, the ensemble spread approximately matched the corresponding root mean square errors. Reducing the number of ensemble members led to slightly larger errors across all variables due to the introduction of larger sampling errors into the system.

Incorporating Graphene Oxide (GO) in concrete composite has been a good alternative to Pristine Graphene due to its hydrophilic nature and its ability to readily disperse in water the consequent cementitious mix. The addition of GO to the cementitious mix has been found to enhance mechanical properties. This paper aims to assess the abrasion resistance of GO incorporated concrete for its application in road pavement design. Experiments for strength in terms of compression, workability in terms of slump and abrasion resistance in accordance with ASTM-C418-20 using a sand-blasting rig are presented in the paper. It is shown that the addition of GO at percentages between 0% to 0.08% (to cement weight ratio), the compressive strength improves by 39% and 26% at 7 days and 28 days, respectively. The addition of GO consequently affected the workability where it was found that the addition of polycarboxylate ether (PCE) (superplasticisers) can drastically improve the workability, which is essential in practical applications. The abrasion was measured for specimens prepared with a high GO percentage between 0.1% to 0.3% and measured at 7 days and displayed a reduction of 70% of abraded volume at 0.3% GO. Finally, the study presents the benefits of using GO where the reduced amount of cement usage will consequently lead to sustainable concrete construction.

BackgroundChildren with cerebral palsy (CP) show progressive loss of ambulatory function characterized by kinematic deviations at the hip, knee, and ankle. Functional electrical stimulation (FES) can lead to more typical lower limb kinematics during walking by eliciting appropriately timed muscle contractions. FES-assisted walking interventions have shown mixed to positive results in improving lower limb kinematics through immediate correction of gait during the application of FES, or long-term, persisting effects of non-FES-assisted gait improvements following multi-week FES-assisted gait training, at the absence of stimulation, i.e., neurotherapeutic effects. It is unknown, however, if children with CP will demonstrate a neurotherapeutic response following FES-assisted gait training because of the CP population's heterogeneity in gait deviations and responses to FES. Identifying the neurotherapeutic responders is, therefore, important to optimize the training interventions to those that have higher probability of benefiting from the intervention.ObjectiveThe purpose of this case study was to investigate the relationship between immediate and neurotherapeutic effects of FES-assisted walking to identify responders to a FES-assisted gait training protocol.MethodsThe primary outcome was Gait Deviation Index (GDI) and secondary outcome was root mean squared error (RMSE) of the lower extremity joint angles in the sagittal plane between participants with CP and a typically developing (TD) dataset. Potential indicators were defined as immediate improvements from baseline during FES-assisted walking followed by neurotherapeutic improvements at the end of training.Case descriptionGait analysis of two adolescent female participants with spastic diplegia (Gross Motor Function Classification System level II and III) was conducted at the start and end of a 12-week FES-assisted treadmill training protocol. Participant 1 had scissoring crouch gait, while participant 2 had jump gait.OutcomesThe GDI showed both immediate (presence of FES) and neurotherapeutic (absence of FES after training period) improvements from baseline in our two participants. Joint angle RMSE showed mixed trends between immediate and neurotherapeutic changes from baseline. The GDI warrants investigation in a larger sample to determine if it can be used to identify responders to FES-assisted gait training.

Machine learning-based gait systems facilitate the real-time control of gait assistive technologies in neurological conditions. Improving such systems needs the identification of kinematic signals from inertial measurement unit wearables (IMUs) that are robust across different walking conditions without extensive data processing. We quantify changes in two kinematic signals, acceleration and angular velocity, from IMUs worn on the frontal plane of bilateral shanks and thighs in 30 adolescents (8–18 years) on a treadmills and outdoor overground walking at three different speeds (self-selected, slow, and fast). Primary curve-based analyses included similarity analyses such as cosine, Euclidean distance, Poincare analysis, and a newly defined bilateral symmetry dissimilarity test (BSDT). Analysis indicated that superior–inferior shank acceleration (SI shank Acc) and medial–lateral shank angular velocity (ML shank AV) demonstrated no differences to the control signal in BSDT, indicating the least variability across the different walking conditions. Both SI shank Acc and ML shank AV were also robust in Poincare analysis. Secondary parameter-based similarity analyses with conventional spatiotemporal gait parameters were also performed. This normative dataset of walking reports raw signal kinematics that demonstrate the least to most variability in switching between treadmill and outdoor walking to help guide future machine learning models to assist gait in pediatric neurological conditions.

Individuals with cerebral palsy (CP) have deficits in processing of somatosensory and proprioceptive information. To compensate for these deficits, they tend to rely on vision over proprioception in single plane upper and lower limb movements and in standing. It is not known whether this also applies to walking, an activity where the threat to balance is higher. Through this study, we used visual perturbations to understand how individuals with and without CP integrate visual input for walking balance control. Additionally, we probed the balance mechanisms driving the responses to the visual perturbations. More specifically, we investigated differences in the use of ankle roll response i.e., the use of ankle inversion, and the foot placement response, i.e., stepping in the direction of perceived fall. Thirty-four participants (17 CP, 17 age-and sex-matched typically developing controls or TD) were recruited. Participants walked on a self-paced treadmill in a virtual reality environment. Intermittently, the virtual scene was rotated in the frontal plane to induce the sensation of a sideways fall. Our results showed that compared to their TD peers, the overall body sway in response to the visual perturbations was magnified and delayed in CP group, implying that they were more affected by changes in visual cues and relied more so on visual information for walking balance control. Also, the CP group showed a lack of ankle response, through a significantly reduced ankle inversion on the affected side compared to the TD group. The CP group showed a higher foot placement response compared to the TD group immediately following the visual perturbations. Thus, individuals with CP showed a dominant proximal foot placement strategy and diminished ankle roll response, suggestive of a reliance on proximal over distal control of walking balance in individuals with CP.

Incorporating Graphene Oxide (GO) in concrete composite has been a good alternative to Pristine Graphene due to its hydrophilic nature and its ability to readily disperse in water the consequent cementitious mix. The addition of GO to the cementitious mix has been found to enhance mechanical properties. This paper aims to assess the abrasion resistance of GO incorporated concrete for its application in road pavement design. Experiments for strength in terms of compression, workability in terms of slump and abrasion resistance in accordance with ASTM-C418-20 using a sand-blasting rig are presented in the paper. It is shown that the addition of GO at percentages between 0% to 0.08% (to cement weight ratio), the compressive strength improves by 39% and 26% at 7 days and 28 days, respectively. The addition of GO consequently affected the workability where it was found that the addition of polycarboxylate ether (PCE) (superplasticisers) can drastically improve the workability, which is essential in practical applications. The abrasion was measured for specimens prepared with a high GO percentage between 0.1% to 0.3% and measured at 7 days and displayed a reduction of 70% of abraded volume at 0.3% GO. Finally, the study presents the benefits of using GO where the reduced amount of cement usage will consequently lead to sustainable concrete construction.

In the 2016–2017 austral summer, the University of Texas Institute for Geophysics (UTIG) and the Korea Polar Research Institute (KOPRI) collaborated to perform a helicopter-based radar and laser altimeter survey of lower David Glacier with the goals of characterizing the subglacial water distribution that supports a system of active subglacial lakes and informing the site selection for a potential subglacial access drilling project. This survey overlaps with and expands upon an earlier survey of the Drygalski Ice Tongue and the David Glacier grounding zone from 2011 and 2012 to create a 5 km resolution survey extending 200 km upstream from the grounding zone. The surveyed region covers two active subglacial lakes and includes reflights of ICESat ground tracks that extend the surface elevation record in the region. This is one of the most extensive aerogeophysical surveys of an active lake system and provides higher-resolution boundary conditions and basal characterizations that will enable process studies of these features. This paper introduces a new helicopter-mounted ice-penetrating radar and laser altimetry system, notes a discrepancy between the original surface-elevation-derived lake outlines and locations of possible water collection based on basal geometry and hydraulic potential, and presents radar-based observations of basal conditions that are inconsistent with large collections of ponded water despite laser altimetry showing that the hypothesized active lakes are at a highstand.

Stationary cycling is a practical exercise modality in children with cerebral palsy (CP) that lack the strength for upright exercises. However, there is a lack of robust, sensitive metrics that can quantitatively assess the motor control during cycling. The purpose of this brief report was to characterize the differences in motor control of cycling in children with CP and with typical development by developing novel metrics to quantify cycling smoothness and rhythm. Thirty one children with spastic diplegic CP and 10 children with typical development cycled on a stationary cycle. Cycling smoothness was measured by cross-correlating the crank angle with an ideal cycling pattern generated from participant-specific cadence and cycling duration. Cycling rhythmicity was assessed by evaluating the revolution-to-revolution variability in the time required to complete a revolution. Statistically significant differences (p < 0.001) using the Wilcoxon Rank Sum test were found between the two groups for both the metrics. Additionally, decision tree analysis revealed thresholds of smoothness

Sensory dysfunction is prevalent in cerebral palsy (CP). Evidence suggests that sensory deficits can contribute to manual ability impairments in children with CP, yet it is still unclear how they contribute to balance and motor performance. Therefore, the objective of this study was to investigate the relationship between lower extremity (LE) somatosensation and functional performance in children with CP. Ten participants with spastic diplegia (Gross Motor Function Classification Scale: I-III) and who were able to stand independently completed the study. Threshold of light touch pressure, two-point discriminatory ability of the plantar side of the foot, duration of cutaneous vibration sensation, and error in the joint position sense of the ankle were assessed to quantify somatosensory function. The balance was tested by the Balance Evaluation System Test (BESTest) and postural sway measures during a standing task. Motor performance was evaluated by using a battery of clinical assessments: (1) Gross Motor Function Measure (GMFM-66-IS) to test gross motor ability; (2) spatiotemporal gait characteristics (velocity, step length) to evaluate walking ability; (3) Timed Up and Go (TUG) and 6 Min Walk (6MWT) tests to assess functional mobility; and (4) an isokinetic dynamometer was used to test the Maximum Volitional Isometric Contraction (MVIC) of the plantar flexor muscles. The results showed that the light touch pressure measure was strongly associated only with the 6MWT. Vibration and two-point discrimination were strongly related to balance performance. Further, the vibration sensation of the first metatarsal head demonstrated a significantly strong relationship with motor performance as measured by GMFM-66-IS, spatiotemporal gait parameters, TUG, and ankle plantar flexors strength test. The joint position sense of the ankle was only related to one subdomain of the BESTest (Postural Responses). This study provides preliminary evidence that LE sensory deficits can possibly contribute to the pronounced balance and motor impairments in CP. The findings emphasize the importance of developing a thorough LE sensory test battery that can guide traditional treatment protocols toward a more holistic therapeutic approach by combining both motor and sensory rehabilitative strategies to improve motor function in CP.

Abstract Background Stochastic Resonance (SR) Stimulation has been used to enhance balance in populations with sensory deficits by improving the detection and transmission of afferent information. Despite the potential promise of SR in improving postural control, its use in individuals with cerebral palsy (CP) is novel. The objective of this study was to investigate the immediate effects of electrical SR stimulation when applied in the ankle muscles and ligaments on postural stability in children with CP and their typically developing (TD) peers. Methods Ten children with spastic diplegia (GMFCS level I- III) and ten age-matched TD children participated in this study. For each participant the SR sensory threshold was determined. Then, five different SR intensity levels (no stimulation, 25, 50, 75, and 90% of sensory threshold) were used to identify the optimal SR intensity for each subject. The optimal SR and no stimulation condition were tested while children stood on top of 2 force plates with their eyes open and closed. To assess balance, the center of pressure velocity (COPV) in anteroposterior (A/P) and medial-lateral (M/L) direction, 95% COP confidence ellipse area (COPA), and A/P and M/L root mean square (RMS) measures were computed and compared. Results For the CP group, SR significantly decreased COPV in A/P direction, and COPA measures compared to the no stimulation condition for the eyes open condition. In the eyes closed condition, SR significantly decreased COPV only in M/L direction. Children with CP demonstrated greater reduction in all the COP measures but the RMS in M/L direction during the eyes open condition compared to their TD peers. The only significant difference between groups in the eyes closed condition was in the COPV in M/L direction. Conclusions SR electrical stimulation may be an effective stimulation approach for decreasing postural sway and has the potential to be used as a therapeutic tool to improve balance. Applying subject-specific SR stimulation intensities is recommended to maximize balance improvements. Overall, balance rehabilitation interventions in CP might be more effective if sensory facilitation methods, like SR, are utilized by the clinicians. Trial registration ClinicalTrials.gov identifier NCT02456376; 28 May 2015 (Retrospectively registered); https://clinicaltrials.gov/ct2/show/NCT02456376.

Recumbent stationary cycling is a potential exercise modality for individuals with cerebral palsy (CP) that lack the postural control needed for upright exercises. Functional electrical stimulation (FES) of lower extremity muscles can help such individuals reach the cycling intensities that are required for aerobic benefits. The aim of this study was to examine the effect of cycling with and without FES assistance to that of a no-intervention control group on the cardiorespiratory fitness of children with CP. Thirty-nine participants were randomized to a FES group that underwent an 8-week FES-assisted cycling program, the volitional group (VOL), who cycled without FES, or a no-intervention control group (CON) (15 FES, 11 VOL, 13 CON). Cadence, peak VO2, and net rise in heart rate were assessed at baseline, end of training, and washout (8-weeks after cessation of training). Latent growth curve modeling was used for analysis. The FES group showed significantly higher cycling cadences than the VOL and CON groups at POST and WO. There were no differences in improvements in the peak VO2 and peak net HR between groups. FES-assisted cycling may help children with CP attain higher cycling cadences and to retain these gains after training cessation. Higher training intensities may be necessary to obtain improvements in peak VO2 and heart rate.

On April 7, 2016 the Nansen ice shelf (NIS) front calved into two icebergs, the first large-scale calving event in >30 years. Three hydrophone moorings were deployed seaward of the NIS in December 2015 and over the following months recorded hundreds of short duration, broadband (10–400 Hz) cryogenic signals, likely caused by fracturing of the ice shelf. The majority of these icequakes occurred between January and early March 2016, several weeks prior to the calving observed by satellite on April 7. Barometric pressure and wind speed records show the day the icebergs drifted from the NIS coincided with the largest low-pressure storm system recorded in the previous 7 months. A nearby seismic station also shows an increase in low-frequency energy, harmonic tremor, and microseisms on April 7. Our interpretation is the northern segment of the NIS leading edge broke free during mid-January to February, producing high acoustic energy, but the icebergs remained stationary until a strong low-pressure system with high winds freed the icebergs. As the unpinning of Antarctic ice shelves is not a well-documented process, our observations show that storm systems may play an under-appreciated role in Antarctic ice shelf break-up.

Functional electrical stimulation (FES) walking interventions have demonstrated improvements to gait parameters; however, studies were often confined to stimulation of one or two muscle groups. Increased options such as number of muscle groups targeted, timing of stimulation delivery, and level of stimulation are needed to address subject-specific gait deviations. We aimed to demonstrate the feasibility of using a FES system with increased stimulation options during walking in children with cerebral palsy (CP). Three physical therapists designed individualized stimulation programs for six children with CP to target participant-specific gait deviations. Stimulation settings (pulse duration and current) were tuned to each participant. Participants donned our custom FES system that utilized gait phase detection to control stimulation to lower extremity muscle groups and walked on a treadmill at a self-selected speed. Motion capture data were collected during walking with and without the individualized stimulation program. Eight gait metrics and associated timing were compared between walking conditions. The prescribed participant-specific stimulation programs induced significant change towards typical gait in at least one metric for each participant with one iteration of FES-walking. FES systems with increased stimulation options have the potential to allow the physical therapist to better target the individual’s gait deviations than a one size fits all device.

We identify two previously unknown subglacial lakes beneath the stagnated trunk of the Kamb Ice Stream (KIS). Rapid fill-drain hydrologic events over several months are inferred from surface height changes measured by CryoSat-2 altimetry and indicate that the lakes are probably connected by a subglacial drainage network, whose structure is inferred from the regional hydraulic potential and probably links the lakes. The sequential fill-drain behavior of the subglacial lakes and concurrent rapid thinning in a channel-like topographic feature near the grounding line implies that the subglacial water repeatedly flows from the region above the trunk to the KIS grounding line and out beneath the Ross Ice Shelf. Ice shelf elevation near the hypothesized outlet is observed to decrease slowly during the study period. Our finding supports a previously published conceptual model of the KIS shutdown stemming from a transition from distributed flow to well-drained channelized flow of subglacial water. However, a water-piracy hypothesis in which the KIS subglacial water system is being starved by drainage in adjacent ice streams is also supported by the fact that the degree of KIS trunk subglacial lake activity is relatively weaker than those of the upstream lakes.

Video- and sensor-based gait analysis systems are rapidly emerging for use in ‘real world’ scenarios outside of typical instrumented motion analysis laboratories. Unlike laboratory systems, such systems do not use kinetic data from force plates, rather, gait events such as initial contact (IC) and terminal contact (TC) are estimated from video and sensor signals. There are, however, detection errors inherent in kinematic gait event detection methods (GEDM) and comparative study between classic laboratory and video/sensor-based systems is warranted. For this study, three kinematic methods: coordinate based treadmill algorithm (CBTA), shank angular velocity (SK), and foot velocity algorithm (FVA) were compared to ‘gold standard’ force plate methods (GS) for determining IC and TC in adults (n = 6), typically developing children (n = 5) and children with cerebral palsy (n = 6). The root mean square error (RMSE) values for CBTA, SK, and FVA were 27.22, 47.33, and 78.41 ms, respectively. On average, GED was detected earlier in CBTA and SK (CBTA: −9.54 ± 0.66 ms, SK: −33.41 ± 0.86 ms) and delayed in FVA (21.00 ± 1.96 ms). The statistical model demonstrated insensitivity to variations in group, side, and individuals. Out of three kinematic GEDMs, SK GEDM can best be used for sensor-based gait event detection.

A recently designed gait phase detection (GPD) system, with the ability to detect all seven phases of gait in healthy adults, was modified for GPD in children with cerebral palsy (CP). A shank-attached gyroscope sent angular velocity to a rule-based algorithm in LabVIEW to identify the distinct characteristics of the signal. Seven typically developing children (TD) and five children with CP were asked to walk on treadmill at their self-selected speed while using this system. Using only shank angular velocity, all seven phases of gait (Loading Response, Mid-Stance, Terminal Stance, Pre-Swing, Initial Swing, Mid-Swing and Terminal Swing) were reliably detected in real time. System performance was validated against two established GPD methods: (1) force-sensing resistors (GPD-FSR) (for typically developing children) and (2) motion capture (GPD-MoCap) (for both typically developing children and children with CP). The system detected over 99% of the phases identified by GPD-FSR and GPD-MoCap. Absolute values of average gait phase onset detection deviations relative to GPD-MoCap were less than 100 ms for both TD children and children with CP. The newly designed system, with minimized sensor setup and low processing burden, is cosmetic and economical, making it a viable solution for real-time stand-alone and portable applications such as triggering functional electrical stimulation (FES) in rehabilitation systems. This paper verifies the applicability of the GPD system to identify specific gait events for triggering FES to enhance gait in children with CP.

Splinter or foreign body removal from the hand and foot is a common occurrence. Usually only the deep seated, broken or missed splinters are referred to the surgeon for removal. Unless the object is radio-opaque, plain radiograph will not give any useful information, hence removal can sometimes be very difficult and traumatic. We are reporting a case where a radiolucent splinter was removed with the aid of ultrasonography. This modality can help to localize a splinter at the pre and intra-operative period, minimizing amount of exploration and time of operation.

Introduction. Adolescents with cerebral palsy (CP) often have difficulty participating in exercise at intensities necessary to improve cardiovascular fitness. Functional electrical stimulation- (FES-) assisted cycling is proposed as a form of exercise for adolescents with CP. The aims of this paper were to adapt methods and assess the feasibility of applying FES cycling technology in adolescents with CP, determine methods of performing cycling tests in adolescents with CP, and evaluate the immediate effects of FES assistance on cycling performance. Materials/Methods. Four participants (12–14 years old; GMFCS levels III-IV) participated in a case-based pilot study of FES-assisted cycling in which bilateral quadriceps muscles were activated using surface electrodes. Cycling cadence, power output, and heart rate were collected. Results. FES-assisted cycling was well tolerated (n=4) and cases are presented demonstrating increased cadence (2–43 rpm), power output (19–70%), and heart rates (4-5%) and decreased variability (8–13%) in cycling performance when FES was applied, compared to volitional cycling without FES assistance. Some participants (n=2) required the use of an auxiliary hub motor for assistance. Conclusions. FES-assisted cycling is feasible for individuals with CP and may lead to immediate improvements in cycling performance. Future work will examine the potential for long-term fitness gains using this intervention.