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Research on human posture and balance control has grown in recent years, leading to continued advances in their understanding. The ability to maintain balance is attributed to the interplay of the visual, vestibular, and somatosensory systems, although an important role is also played by the auditory system. The lack or deficit in any of these systems leads to a reduced stability that may be counterbalanced by the integration of all the remaining sensory information. Auditory and vibratory stimulation have been found to be useful to enhance balance alongside daily activities either in healthy or pathological subjects; nevertheless, while widely investigated, the literature relating to these approaches is still fragmented. This review aims at addressing this by collecting, organising, and discussing all the literature to date on the effects of the various acoustic and vibratory stimulation techniques available on static upright posture in healthy subjects. In addition, this review intends to provide a solid and comprehensive starting point for all the researchers interested in these research areas. A systematic search of the literature was performed and a total of 33 articles (24 on vibratory stimulation and 9 on acoustic stimulation) were included in our analysis. For all articles, several elements were highlighted including: the study sample, the characteristics of the stimulations, the recording instruments, the experimental protocols, and outcomes. Overall, both stimulations analysed were found to have a positive effect on balance but more research is needed to align those alternative approaches to the traditional ones.

Postural control is a complex feedback system that relies on vast array of sensory inputs in order to maintain a stable upright stance. The brain cortex plays a crucial role in the processing of this information and in the elaboration of a successful adaptive strategy to external stimulation preventing loss of balance and falls. In the present work, the participants postural control system was challenged by disrupting the upright stance via a mechanical skeletal muscle vibration applied to the calves. The EEG source connectivity method was used to investigate the cortical response to the external stimulation and highlight the brain network primarily involved in high-level coordination of the postural control system. The cortical network reconfiguration was assessed during two experimental conditions of eyes open and eyes closed and the network flexibility (i.e. its dynamic reconfiguration over time) was correlated with the sample entropy of the stabilogram sway. The results highlight two different cortical strategies in the alpha band: the predominance of frontal lobe connections during open eyes and the strengthening of temporal-parietal network connections in the absence of visual cues. Furthermore, a high correlation emerges between the flexibility in the regions surrounding the right temporo-parietal junction and the sample entropy of the CoP sway, suggesting their centrality in the postural control system. These results open the possibility to employ network-based flexibility metrics as markers of a healthy postural control system, with implications in the diagnosis and treatment of postural impairing diseases.

Efficient postural control results from an effective interplay between sensory feedbacks integration and muscle modulation and can be affected by ageing and neuromuscular injuries. With this study, we investigated the effect of whole-body vibratory stimulation on postural control strategies employed to maintain an upright posture. We explored both physiological and posturography metrics, through corticomuscular and intramuscular coherence, and muscle networks analyses. The stimulation disrupts balance in the short term, but leads to a greater contribution of cortical activity, necessary to modulate muscle activation via the formation of (new) synergies. We also observed a reconfiguration of muscle recruitment patterns that returned to pre-stimulation levels after few minutes, accompanied by a slight improvement of balance in the anterior–posterior direction. Our results suggest that, in the context of postural control, appropriate mechanical stimulation is capable of triggering a recalibration of the sensorimotor set and might offer new perspectives for motor re-education.

Synthetic data augmentation is of paramount importance for machine learning classification, particularly for biological data, which tend to be high dimensional and with a scarcity of training samples. The applications of robotic control and augmentation in disabled and able-bodied subjects still rely mainly on subject-specific analyses. Those can rarely be generalised to the whole population and appear to over complicate simple action recognition such as grasp and release (standard actions in robotic prosthetics and manipulators). We show for the first time that multiple GPT-2 models can machine-generate synthetic biological signals (EMG and EEG) and improve real data classification. Models trained solely on GPT-2 generated EEG data can classify a real EEG dataset at 74.71% accuracy and models trained on GPT-2 EMG data can classify real EMG data at 78.24% accuracy. Synthetic and calibration data are then introduced within each cross validation fold when benchmarking EEG and EMG models. Results show algorithms are improved when either or both additional data are used. A Random Forest achieves a mean 95.81% (1.46) classification accuracy of EEG data, which increases to 96.69% (1.12) when synthetic GPT-2 EEG signals are introduced during training. Similarly, the Random Forest classifying EMG data increases from 93.62% (0.8) to 93.9% (0.59) when training data is augmented by synthetic EMG signals. Additionally, as predicted, augmentation with synthetic biological signals also increases the classification accuracy of data from new subjects that were not observed during training. A Robotiq 2F-85 Gripper was finally used for real-time gesture-based control, with synthetic EMG data augmentation remarkably improving gesture recognition accuracy, from 68.29% to 89.5%.

For decades, postural control has been believed to be dominated by reflexive mechanisms, but more recent evidence characterizes it as an articulate system which relies on multisensory integration (vestibular, visual, proprioceptive) and cortical coordination to preserve balance in the wake of external disruptions to the quiet stance. Corrective strategies to stabilise the body’s center of mass and prevent falls are planned at the central nervous system level and executed through the modulation of muscular activity, especially in the lower legs muscles: gastrocnemius, soleus and tibialis. In this study, we use localized proprioceptive vibratory stimulation to induce a perturbation of the subjects’ quiet stance. By integrating traditional force plate data with electrophysiological signals (EEG and EMG), we use cortico-muscular and inter-muscular coherence to investigate how brain and muscles interact to shape an effective response to a postural challenge. Our results show how the cortical drive is enhanced in beta [13-30]Hz and gamma [30-45]Hz bands, specifically for the soleus and gastrocnemius muscles, during the task execution. We also reveal a remodulation of the lower legs muscle network, with a distributed strengthening of muscle activity coupling.

The objective of the present work is to measure postural kinematics and power spectral variation from HD-EEG to assess changes in cortical activity during adaptation and habituation to postural perturbation. To evoke proprioceptive postural perturbation, vibratory stimulation at 85 Hz was applied to the calf muscles of 33 subjects over four 75-second stimulation periods. Stimulation was performed according to a pseudorandom binary sequence. Vibratory impulses were synchronized to high-density electroencephalography (HD-EEG, 256 channels). Changes in absolute spectral power (ASP) were analyzed over four frequency bands (Delta: 0.5-3.5 Hz; theta: 3.5-7.5 Hz; alpha: 7.5-12.5 Hz; beta:12.5-30 Hz). A force platform recorded torque actuated by the feet, and normalized sway path length (SPL) was computed as a construct for postural performance during each period. SPL values indicated improvement in postural performance over the trial periods. Significant variation in absolute power values (ASP) was found in assessing postural adaptation: an increase in theta band ASP in the frontal-central region for closed-eyes trials, an increase in theta and beta band ASP in the parietal region for open-eyes trials. In habituation, no significant variations in ASP were observed during closed-eyes trials, whereas an increase in theta, alpha, and beta band ASP was observed with open eyes. Furthermore, open-eyed trials generally yielded a greater number of significant ASP differences across all bands during both adaptation and habituation, suggesting that following cortical activity during postural perturbation may be up-regulated with the availability of visual feedback. Results provide deeper insight into pathological postural control failure by exploring the dynamic changes in both cortical activity and postural kinematics during adaptation and habituation to proprioceptive postural perturbation., 6 figures

Purpose: This study aimed to translate the Convergence Insufficiency Symptom Survey (CISS) into the Italian language and assess psychometric properties of the translated questionnaire (CISS_I). Methods: The CISS_I was arranged according to guidelines for a comprehensive multistep methodologic process for translating, adapting, and validating psychometric instruments in health care research. The CISS_I questionnaire was administered to 103 volunteers (21.8 ± 2.2 years), students in higher education, at two different times. A complete optometric evaluation was performed including subjective refraction, best corrected visual acuity, near point of convergence, prism fusional ranges to blur, diplopia and recovery, TNO stereo test and prism cover test for measurement of heterophoria. Results: The performance of the CISS_I in terms of validity showed some points of weakness. Sensitivity was 42%, specificity was 74%, positive predictive value was 27% and negative predictive value was 85%. The area under the ROC curve was 0.672. On the contrary, the results showed good internal consistency of the CISS_I (Cronbach's alpha - α=0.89) and good test-retest reliability (ICC = 0.92). Rasch analysis showed good model fit (all items, except one, with infit and outfit mean square between 0.7 and 1.3), good measurement precision (person separation = 2.66) and good targeting –0,81 logits but also some evidence of multidimensionality. Conclusions: The CISS_I showed some point of weakness in terms of validity but also good psychometric properties and has been shown to be applicable to an Italian speaking population to quantify the visual discomfort associated with near vision in higher education students. The results show that high CISS_I score is not necessarily linked to convergence insufficiency, while low scores can exclude the presence of this anomaly. The CISS_I can help in interpreting and monitoring convergence insufficiency symptoms in already identified subjects, but it is not suitable for screening a general population of young adults.

Lower limb muscles actively contribute to maintain body posture but also act to attenuate soft tissues oscillations that occur during everyday life. This elicited activity can be exploited as a mean of neuromuscular training or rehabilitation. In this study, Whole Body Vibrations (WBV) at different frequencies were delivered to healthy subjects while holding static postures to test the transient muscles mechanical responses. Twenty-five participants underwent WBV at 15, 20, 25 and 30 Hz while holding either a static ‘hack squat’ or ‘fore feet’ posture. Soft tissue accelerations and surface electromyography (sEMG) were recorded from Gastrocnemius Lateralis (GL), Soleus (SOL) and Tibialis Anterior (TA) muscles. Estimated displacement at muscle bellies revealed a resonant pattern, different across frequencies and postures (p

PurposeTo characterise the mechanical and neuromuscular response of lower limb muscles in subjects undergoing Whole Body Vibration (WBV) at different frequencies while holding two static postures.MethodsTwenty-five participants underwent WBV at 15, 20, 25 and 30 Hz while holding a static ‘hack squat’ and on ‘fore feet’ posture. Surface electromyography (sEMG) and soft tissue accelerations were collected from Gastrocnemius Lateralis (GL), Soleus (SOL) and Tibialis Anterior (TA) muscles.ResultsOnly specific WBV settings led to a significant increase in muscle contraction. Specifically, the WBV-induced activation of SOL and GL was maximal in fore-feet and in response to higher frequencies. Estimated displacement at muscle bellies revealed a resonant pattern never highlighted before. After stimulation starts, muscle oscillation reaches a peak followed by a drop and a further stabilisation (few seconds after the peak) that suggests the occurrence of a neuromuscular activation to reduce the vibration-induced oscillation.ConclusionLower leg muscles need a response time to tune to a vibratory stimulation, which discourages the use of dynamic exercises on vibrating platforms. To maximize calf muscle response to WBVs, a stimulation frequency in the range of 25-30 Hz and an ‘on fore feet’ posture are recommended.

X-ray fluoroscopy is a medical imaging modality that provides continuous real-time screening of patient’s organs and various radiopaque surgical objects. Fluoroscopy usually requires long and unpredictable exposure times, thus radiation intensity must be heavily reduced to limit patient’s dose. This gives rise to the well-known Poisson noise, which results in very poor image quality. Commercial fluoroscopes usually improve image quality via real-time temporal averaging, which produces motion blur in moving scenes. The Noise Variance Conditioned Average (NVCA) algorithm exploits the a priori knowledge of Poisson noise statistics to provide efficient noise reduction, while preserving the edges of moving objects. However, accurate setting of NVCA parameters is required to achieve the best results, and this could be supported by image quality assessment (IQA) indices. This study presents a novel, edge-aware IQA index, named Sensitivity of Edge Detection (SED), and compares it against the well-established Feature Similarity (FSIM) index, to assess their efficiency in determining the optimal parameters for NVCA. The preliminary results obtained in this study suggest SED could be more efficient than FSIM in identifying the best trade-off between noise reduction and edge preservation, and could be also used to determine the optimal parameters of other denoising algorithms.

Comparison of derivative operators via quantitative performance analysis is rarely addressed in medical imaging. Indeed, the main application of such operators is the extraction of edges and, since there is no unequivocal definition of edges, the common trend is to identify the best performing operator based on a qualitative match between the extracted edges and the fickle human perception of object boundaries. This study presents an objective comparison of four first-order derivative operators through quantitative analysis of results yielded in a specific task, i.e. a spine kinematics application. Such application is based on a template matching method, which estimates common kinematic parameters of intervertebral segments from an X-ray fluoroscopy sequence of spine motion, by operating on the image derivatives of each frame. Therefore, differences in image derivatives, computed via different derivative operators, may lead to differences in estimated parameters of intervertebral kinematics. The comparison presented in this study focused on the trajectory of the instantaneous center of rotation (ICR) of an intervertebral segment, as it is particularly sensitive even to very small differences in displacements and velocities. Therefore, a quantitative analysis of the discrepancies between the ICR trajectories, obtained with each of the four considered derivative operators, was carried out by defining quantitative measures. The results showed detectable differences in the obtained ICR trajectories, thus highlighting the need for quantitative analysis of derivative operator performances in applications aimed at providing quantitative results. However, the significance level of such differences for clinical applications should be further assessed, but, currently, it is not possible, as there is no consensus and sufficient data on kinematic parameters features associated with specific spinal pathologies.

Human machine interfaces (HMIs) are employed in a broad range of applications, spanning from assistive devices for disability to remote manipulation and gaming controllers. In this study, a new piezoresistive sensors array armband is proposed for hand gesture recognition. The armband encloses only three sensors targeting specific forearm muscles, with the aim to discriminate eight hand movements. Each sensor is made by a force-sensitive resistor (FSR) with a dedicated mechanical coupler and is designed to sense muscle swelling during contraction. The armband is designed to be easily wearable and adjustable for any user and was tested on 10 volunteers. Hand gestures are classified by means of different machine learning algorithms, and classification performances are assessed applying both, the 10-fold and leave-one-out cross-validations. A linear support vector machine provided 96% mean accuracy across all participants. Ultimately, this classifier was implemented on an Arduino platform and allowed successful control for videogames in real-time. The low power consumption together with the high level of accuracy suggests the potential of this device for exergames commonly employed for neuromotor rehabilitation. The reduced number of sensors makes this HMI also suitable for hand-prosthesis control.

Modern 3D printing technologies and wide availability of microcontroller boards allow to make active prosthetic devices in a simple way. This is the case of “Federica”, a very low-cost, under-actuated, active hand prosthesis. The five fingers of the prosthesis are moved by a single motor through inelastic tendons. The control system of the prosthesis is proportional to muscle contraction: firstly, EMG was used, then mechanical sensors that measure muscle volumetric variation were successfully utilized. This prosthesis proved to be particularly energy efficient and fast; it provided a general grasp function by adapting the exerted forces, thus allowing to easily catch even deformable objects. This study presents further analyses and design improvements of this prosthesis. In particular, a new, extremely simple but effective conditioning system of a force sensor resistor was presented and tested. In addition, the actual three-dimensional kinematics of a single finger was captured by means of high frame rate cameras and then analyzed. The new sensor conditioning system was characterized. It proved to be as effective as the EMG envelope to proportionally control the hand prosthesis motion, and it allowed an easier connection to common microcontroller boards. Kinematic analysis allowed to accurately reconstruct the actual phalanges motion over time.

This paper presents forcecardiography (FCG), a novel technique to measure local, cardiac-induced vibrations onto the chest wall. Since the 19th century, several techniques have been proposed to detect the mechanical vibrations caused by cardiovascular activity, the great part of which was abandoned due to the cumbersome instrumentation involved. The recent availability of unobtrusive sensors rejuvenated the research field with the most currently established technique being seismocardiography (SCG). SCG is performed by placing accelerometers onto the subject&rsquo, s chest and provides information on major events of the cardiac cycle. The proposed FCG measures the cardiac-induced vibrations via force sensors placed onto the subject&rsquo, s chest and provides signals with a richer informational content as compared to SCG. The two techniques were compared by analysing simultaneous recordings acquired by means of a force sensor, an accelerometer and an electrocardiograph (ECG). The force sensor and the accelerometer were rigidly fixed to each other and fastened onto the xiphoid process with a belt. The high-frequency (HF) components of FCG and SCG were highly comparable (r &gt, 0.95) although lagged. The lag was estimated by cross-correlation and resulted in about tens of milliseconds. An additional, large, low-frequency (LF) component, associated with ventricular volume variations, was observed in FCG, while not being visible in SCG. The encouraging results of this feasibility study suggest that FCG is not only able to acquire similar information as SCG, but it also provides additional information on ventricular contraction. Further analyses are foreseen to confirm the advantages of FCG as a technique to improve the scope and significance of pervasive cardiac monitoring.

International audience; Objective. Maintaining upright posture is a complex task governed by the integration of afferent sensorimotor and visual information with compensatory neuromuscular reactions. The objective of the present work was to characterize the visual dependency and functional dynamics of cortical activation during postural control. Approach. Proprioceptic vibratory stimulation of calf muscles at 85 Hz was performed to evoke postural perturbation in open-eye (OE) and closed-eye (CE) experimental trials, with pseudorandom binary stimulation phases divided into four segments of 16 stimuli. 64-channel EEG was recorded at 512 Hz, with perturbation epochs defined using bipolar electrodes placed proximal to each vibrator. Power spectra variation and linearity analysis was performed via fast Fourier transformation into six frequency bands (Δ, 0.5-3.5 Hz; θ, 3.5-7.5 Hz; α, 7.5-12.5 Hz; β, 12.5-30 Hz; γ_low, 30-50 Hz; and γ_high, 50-80 Hz). Finally, functional connectivity assessment was explored via network segregation and integration analyses. Main Results. Spectra variation showed waveform and vision-dependent activation within cortical regions specific to both postural adaptation and habituation. Generalized spectral variation yielded significant shifts from low to high frequencies in CE adaptation trials, with overall activity suppressed in habituation; OE trials showed the opposite phenomenon, with both adaptation and habituation yielding increases in spectral power. Finally, our analysis of functional dynamics reveals novel cortical networks implicated in postural control using EEG source-space brain networks. In particular, our reported significant increase in local θ connectivity may signify the planning of corrective steps and/or the analysis of falling consequences, while α band network integration results reflect an inhibition of error detection within the cingulate cortex, likely due to habituation. Significance. Our findings principally suggest that specific cortical waveforms are dependent upon the availability of visual feedback, and we furthermore present the first evidence that local and global brain networks undergo characteristic modification during postural control.

Electrocardiography (ECG) has been recently proposed as biometric trait for identification purposes. Intra-individual variations of ECG might affect identification performance. These variations are mainly due to Heart Rate Variability (HRV). In particular, HRV causes changes in the QT intervals along the ECG waveforms. This work is aimed at analysing the influence of seven QT interval correction methods (based on population models) on the performance of ECG-fiducial-based identification systems. In addition, we have also considered the influence of training set size, classifier, classifier ensemble as well as the number of consecutive heartbeats in a majority voting scheme. The ECG signals used in this study were collected from thirty-nine subjects within the Physionet open access database. Public domain software was used for fiducial points detection. Results suggested that QT correction is indeed required to improve the performance. However, there is no clear choice among the seven explored approaches for QT correction (identification rate between 0.97 and 0.99). MultiLayer Perceptron and Support Vector Machine seemed to have better generalization capabilities, in terms of classification performance, with respect to Decision Tree-based classifiers. No such strong influence of the training-set size and the number of consecutive heartbeats has been observed on the majority voting scheme.

Cardiotocographic data provide physicians information about foetal development and permit to assess conditions such as foetal distress. An incorrect evaluation of the foetal status can be of course very dangerous. To improve interpretation of cardiotocographic recordings, great interest has been dedicated to foetal heart rate variability spectral analysis. It is worth reminding, however, that foetal heart rate is intrinsically an uneven series, so in order to produce an evenly sampled series a zero-order, linear or cubic spline interpolation can be employed. This is not suitable for frequency analyses because interpolation introduces alterations in the foetal heart rate power spectrum. In particular, interpolation process can produce alterations of the power spectral density that, for example, affects the estimation of the sympatho-vagal balance (computed as low-frequency/high-frequency ratio), which represents an important clinical parameter. In order to estimate the frequency spectrum alterations of the foetal heart rate variability signal due to interpolation and cardiotocographic storage rates, in this work, we simulated uneven foetal heart rate series with set characteristics, their evenly spaced versions (with different orders of interpolation and storage rates) and computed the sympatho-vagal balance values by power spectral density. For power spectral density estimation, we chose the Lomb method, as suggested by other authors to study the uneven heart rate series in adults. Summarising, the obtained results show that the evaluation of SVB values on the evenly spaced FHR series provides its overestimation due to the interpolation process and to the storage rate. However, cubic spline interpolation produces more robust and accurate results. © 2010 Elsevier Ltd. All rights reserved.

The aim of this study is to highlight the relationship between muscle motion, generated by whole body vibration, and the correspondent electromyographic (EMG) activity and to suggest a new method to customize the stimulation frequency. Simultaneous recordings of EMG and tri-axial accelerations of quadriceps rectus femoris from fifteen subjects undergoing vibration treatments were collected. Vibrations were delivered via a sinusoidal oscillating platform at different frequencies (10-45 Hz). Muscle motion was estimated by processing the accelerometer data. Large EMG motion artifacts were removed using sharp notch filters centred at the vibration frequency and its superior harmonics. EMG-RMS values were computed and analyzed before and after artifact suppression to assess muscular activity. Muscles acceleration amplitude increased with frequency. Muscle displacements revealed a mechanical resonant-like behaviour of the muscle. Resonance frequencies and dumping factors depended on subject. Moreover, RMS of artifact-free EMG was found well correlated (R 2 = 0.82) to the actual muscle displacement, while the maximum of the EMG response was found related to the mechanical resonance frequency of muscle. Results showed that maximum muscular activity was found in correspondence to the mechanical resonance of the muscle itself. Assuming the hypothesis that muscle activation is proportional to muscle displacement, treatment optimization (i.e. to choose the best stimulation frequency) could be obtained by simply monitoring local acceleration (resonance), leading to a more effective muscle stimulation. Motion artifact produced an overestimation of muscle activity, therefore its removal was essential. © 2009 IPEM.

This paper presents an analysis on the suitability of a low cost motion capture system to support the development of generic applications within medical scenarios. In this study we used the Microsoft Kinect (first generation) sensor as basic technology for its wide availability and the relatively low cost, which generated great interest of the scientific community in several application fields. Most of the studies found in literature however, do not address the quality and reliability of the raw data (objects position and depth) considering only the results of the integrated 3D recognition algorithms for the final skeleton/gesture analysis. This can be critical in rehabilitation, in which the knowledge of accuracy, reliability and performance in tracking patient body movements is required and assessed. To this aim, this article proposes an experimental protocol to analyze the Kinect measurement capabilities, via the definition of peculiar parameters. Here we also introduced an analysis of performance versus usage time. Results showed some weak- nesses of the sensor. Specifically, resolution was found in the range of tens of millimeters while degrading over time. The adoption of the Microsoft Kinect (first generation) in medical scenarios should therefore be considered with respect to the application it serves having clear in mind its performances and limitations.

Technological advances have driven some attempt of vital parameters monitoring in adverse environments; these improvements will make possible to monitor cardiac activity also in automotive environments. In this scenario, heart rate changes associated with alcohol consumption, become of great importance to assess the drivers state during time. This paper presents the results of a first set of experiments aimed to discover heart rate variability modification induced by moderate assumption of alcoholic drink (i.e. single draft beer) as that typically occurs in weekend among some people. In the study, twenty subjects were enrolled and for each of them two electrocardiographic recordings were carried out: the first before alcohol ingestion and the second after 25-30 minutes. Each participant remained fasting until the second ECG acquisition was completed. ECG signal were analyzed by typical time-domain, frequency and non linear analysis. Results showed a small increase in LF/HF ratio which reflects a dominance of the sympathetic system over the parasympathetic system, and an increase in signal complexity as proven by non linear analysis. However, the study highlighted the need to monitor HRV starting from alcohol ingestion until its complete metabolization to allow a more precise description of its variation

Infantile Nystagmus Syndrome, or Congenital Nystagmus, is an ocular-motor disorder characterized by involuntary, conjugated and bilateral to and fro ocular oscillations. Good visual acuity in congenital nystagmus can be achieved during the foveation periods in which eye velocity slows down while the target image crosses the fovea. Visual acuity was found to be mainly dependent on the duration of the foveation periods. In this work a new approach is proposed for estimation of foveation parameters: a cubic spline interpolation of the nystagmus recording before localizing the start point of foveation window and to estimate its duration. The performances of the proposed algorithm were assessed in comparison with a previously developed algorithm, used here as gold standard. The obtained results suggest that the spline interpolation could be a useful tool to filter the eye movement recordings before applying an algorithm to estimate the foveation window parameters.

The impact of whole body vibrations (vibration stimulus mechanically transferred to the body) on muscular activity and neuromuscular response has been widely studied but without standard protocol and by using different kinds of exercises and parameters. In this study, we investigated how whole body vibration treatments affect electromyographic signal of rectus femoris during static and dynamic squat exercises. The aim was the identification of squat exercise characteristics useful to maximize neuromuscular activation and hence progress in training efficacy. Fourteen healthy volunteers performed both static and dynamic squat exercises without and with vibration treatments. Surface electromyographic signals of rectus femoris were recorded during the whole exercise and processed to reduce artifacts and to extract root mean square values. Paired t-test results demonstrated an increase of the root mean square values (p

The abomasal or intravenous infusion of sulphur-containing amino acids such as cysteine or methionine into sheep on low-quality diets increases the sulphur content of the wool by increasing the synthesis of proteins containing a cysteine content of approximately 30 mol %. To investigate the molecular and cellular basis of this nutritional effect, quantitative analyses of wool keratin mRNA and protein levels, and follicle cortical cell type, were undertaken in sheep intravenously infused with cysteine. Northern blot analyses revealed that the mRNA levels of one gene family encoding cysteine-rich keratin-associated proteins (KAP4 family) expressed in the wool follicle cortex, increased approximately 5-6 times. Furthermore, the response was rapid as the mRNA levels increased approximately 3.5 times after 1 d of the cysteine infusion and, by 1 d post-infusion, they had fallen, approaching their basal level. No changes in the mRNA levels encoding the intermediate filament or the other keratin-associated protein families of lower cysteine content were observed. Concomitantly, two-dimensional polyacrylamide gel electrophoresis analysis of wool proteins showed a striking increase in the abundance of a group of cysteine-rich keratin-associated proteins in the wool by the end of the infusion period, returning to basal levels by 3 weeks later. At the cellular level, KAP4 expression was localized to the follicle paracortical cells, and the proportion of paracortical cells and the extent of KAP4 expression paralleled the changes in the cysteine infusion status of the sheep.

— Long term recording of biomedical signals such as ECG, EMG, respiration and other information (e.g. body motion) can improve diagnosis and potentially monitor the evolution of many widespread diseases. However, long term monitoring requires specific solutions, portable and wearable equipment that should be particularly comfortable for patients. The key-issues of portable biomedical instrumentation are: power consumption, long-term sensor stability, comfortable wearing and wireless connectivity. In this scenario, it would be valuable to realize prototypes using available technologies to assess long-term personal monitoring and foster new ways to provide healthcare services. The aim of this work is to discuss the advantages and the drawbacks in long term monitoring of biopotentials and body movements using textile electrodes embedded in clothes. The textile electrodes were embedded into garments; tiny shirt and short were used to acquire electrocardiographic and electromyographic signals. The garment was equipped with low power electronics for signal acquisition and data wireless transmission via Bluetooth. A small, battery powered, biopotential amplifier and three-axes acceleration body monitor was realized. Patient monitor incorporates a microcontroller, analog-to-digital signal conversion at programmable sampling frequencies. The system was able to acquire and to transmit realtime signals, within 10 m range, to any Bluetooth device (including PDA or cellular phone). The electronics were embedded in the shirt resulting comfortable to wear for patients. Small size MEMS 3-axes accelerometers were also integrated.

In hair differentiation several families of keratin proteins with distinctive amino acid compositions are produced. To study the role and regulation of one of these families, the glycine/tyrosine-rich keratin-associated proteins encoded by the KAP6 gene family, a partial wool follicle cDNA clone encoding a sheep KAP6 protein was sequenced and the corresponding gene isolated from a sheep cosmid library. The KAP6.1 gene encodes a basic protein of 82 amino acids (M(r) = 8,296) with a combined glycine and tyrosine content of approximately 60 mol%. There are several KAP6 genes in the sheep genome, all located within a 1,050-kilobase SfiI fragment. Northern blot analysis demonstrated that at least one member of the KAP6 family is expressed in the wool follicle. A rabbit KAP6 gene was isolated and its sequence and expression patterns were compared with the sheep gene. The sheep and rabbit genes have a nucleotide sequence identity of 89%, suggesting that they are equivalent genes and indicating strong selection pressure during evolution. Both genes contain several conserved sequence motifs of 7-9 nucleotides in their 5'-flanking regions that may be involved in the regulation of their expression. Localization of KAP6 mRNAs in sheep wool and rabbit hair follicles by in situ hybridization suggests that the genes are expressed in the cells of the hair shaft cortex in varying expression patterns. KAP6 expression starts relatively late in hair follicle differentiation, and the proportion of hair cortical cells that express it may change from follicle to follicle.

The aim of this study is to highlight the relation between muscle motion and electromyographyc activity during whole body vibration. This treatment is accounted for eliciting a reflex muscle activity in response to vibratory stimulation. Simultaneous recordings from quadriceps Rectus Femoris EMG and 3D muscle accelerations on fifteen subjects undergoing vibration treatments were collected. In our study vibrations were delivered via a sinusoidal oscillating platform at different frequencies (10-45 Hz), with a constant amplitude. Muscle motion was estimated by processing accelerometer data. Displacements revealed a mechanical resonant-like behaviour of the muscle; resonance frequencies and dumping factors depended on subject. Large EMG motion artifacts were removed using sharp notch filters centred at the vibration frequency and its superior harmonics. RMS values of artifact-free EMG were found correlated to the actual muscle displacement. The results were in accordance to the hypothesis of a proprioceptive response during vibration treatment. Nevertheless, motion artifacts produced an overestimation of muscle activity, therefore its removal was essential. © 2009 Springer Berlin Heidelberg.

A valuable alternative to US cardiotocography, for fetal surveillance, can be offered by phonocardiography, a passive and low cost acoustic recording of fetal heart sounds. A crucial point is the exact recognizing of the fetal heart sounds, associated to each fetal heart beat, and then the estimation of FHR signal. In this work, software for FHR assessment from phonocardiographic signals was developed. To check the reliability of the software, obtained results were compared with those of simultaneously recorded cardiotocographic signals. Results seemed to be satisfying, as provided FHR series were almost all confined within FHR-CTG +/- 3 bpm, where FHR-CTG were FHR series provided by commercial US cardiotocographic devices, currently employed in clinical routine.

Congenital nystagmus (CN) is an ocular-motor disorder characterised by involuntary, conjugated ocular oscillations, that can arise since the first months of life. Pathogenesis of congenital nystagmus is still under investigation. In general, CN patients show a considerable decrease of their visual acuity: image fixation on the retina is disturbed by nystagmus continuous oscillations, mainly horizontal. However, image stabilisation is still achieved during the short periods in which eye velocity slows down while the target image is placed onto the fovea (called foveation intervals). To quantify the extent of nystagmus, eye movement recording are routinely employed, allowing physicians to extract and analyse nystagmus main features such as shape, amplitude and frequency. Using eye movement recording, it is also possible to compute estimated visual acuity predictors: analytical functions which estimates expected visual acuity using signal features such as foveation time and foveation position variability. Use of those functions add information to typical visual acuity measurement (e.g. Landolt C test) and could be a support for therapy planning or monitoring. This study focus on robust detection of CN patients' foveations. Specifically, it proposes a method to recognize the exact signal tracts in which a subject foveates, This paper also analyses foveation sequences. About 50 eyemovement recordings, either infrared-oculographic or electrooculographic, from different CN subjects were acquired. Results suggest that an exponential interpolation for the slow phases of nystagmus could improve foveation time computing and reduce influence of breaking saccades and data noise. Moreover a concise description of foveation sequence variability can be achieved using non-fitting splines. © 2009 Springer Berlin Heidelberg.

Congenital nystagmus (CN) is an ocular-motor disorder that appears at birth or during the first few months of life; it is characterised by involuntary, conjugated, bilateral to and fro ocular oscillations. Pathogenesis of congenital nystagmus is still unknown. Eye movement recording allow to extract and analyse nystagmus main features such as shape, amplitude and frequency; depending on the morphology of the oscillations nystagmus can be classified in different categories (pendular, jerk, horizontal unidirectional, bidirectional). In general, CN patient show a considerable decrease of the visual acuity: image fixation on the retina is disturbed by nystagmus continuous oscillations; however, image stabilisation is still achieved during the short foveation periods in which eye velocity slows down while the target image is placed onto the fovea. Visual acuity was found to be mainly dependent on foveation periods duration, but cycle-to-cycle foveation repeatability and reduction of retinal image velocities also contribute in increasing visual acuity. This study concentrate on cycle-to-cycle image position variation onto fovea, trying to characterise the sequences of foveation positions. Eye-movement (infrared oculographic or electro oculographic) recordings, relative to different gaze positions and belonging to more than 30 CN patients, were analysed. Preliminary results suggest that sequences of foveations show a cyclic pattern with a dominant frequency (around 0.3 Hz on average) much lower than that of the nystagmus (about 3.3 Hz on average). Sequences of foveations reveals an horizontal ocular swing of more than 2 degree on average, which can explain the low visual acuity of the CN patient. Current CN therapies, pharmacological treatment or surgery of the ocular muscles, mainly aim to increase the patient's visual acuity. Hence, it is fundamental to have an objective parameter (expected visual acuity) for therapy planning. The information about sequences of foveations can improve estimation of patient visual acuity.

Discussion: Each sensor on the pressure mat is 0.7 cm 2 in area. Since the error for the COP coordinates are less than the size of the sensor, the discrepancies between the two software packages can be considered negligible. Regarding the COP accuracy, the resulting errors are less than 4% of the subject’s applied pressure and can therefore be considered minor. Further studies are required to verify the repeatability of these results. Following will be a full integration with an ad hoc SR already in use in the laboratory. References

Cardiotocography is the most commonly used noninvasive diagnostic technique that provides physicians information about fetal development (in particular about development of autonomous nervous system - ANS) and wellbeing. It allows the simultaneous recording of Fetal Heart Rate (FHR), by means of a Doppler probe, and Uterine Contractions (UC), by means of an indirect pressure transducer. Currently, in cardiotocographic devices, Doppler methodology involves autocorrelation techniques to recognize heart beats, so evaluation of inter-beats time-interval is very improved. However, recorded FHR signals may contain artifacts, because of the possible degradation, or even less, of the Doppler signal due to relative motion between probe and fetal heart, maternal movements, muscle contractions and other causes. Moreover, fetal cardiac arrhythmias can have an effect on FHR signals. These arrhythmias do not represent an expression of the physiological behavior of the ANS. Both, artifacts and cardiac arrhythmias represent outliers of the FHR signals, so they affect both time domain and time frequency signal analysis.

Whole Body Vibration training is more and more utilized in sport medicine to enhance athletic performance and training; recently, vibration treatment is being also used for therapy and rehabilitation for patients affected by different pathologies. It is also worth mention that excessive vibrations can be hazardous. The treatment is based on the hypothesis that under some circumstances vibration loads induce specific responses from the neuromuscular system; some clinical evidences suggest mechanical and metabolic reaction. Usually, vibrations are transmitted by means of a platform oscillating at different frequencies (10-80Hz) to patient body; mainly, limb muscles are involved. Many studies about the subject employ surface EMG recordings to evaluate muscle activity during vibration training. On electrodes, this condition generates large motion artifact at the vibration frequency. To get rid of such artifact an adaptive filter was designed: accelerometers placed onto platform or directly on muscles provide an error signal shape to be cancelled from the raw EMG. In particular, surface EMG have been recorded from leg quadriceps muscles of volunteers during whole body vibration therapy sessions at different oscillating frequency. A standard RLS adaptive filter have been used to cancel the motion artifact from EMG in real-time. Results show the effective cancellations of the vibration frequency from the raw EMG; the RMS value of the cleaned EMG results lower than that unprocessed in some cases up to 50%.

Congenital nystagmus (CN) is a disturbance of the oculomotor centers which develops at birth or in the first months of life. Nystagmus consists essentially in involuntary, conjugated, horizontal rhythmic movements of the eye. Its pathogenesis is still unknown. Current therapies for CN aim to increase the patient’s visual acuity by means of refraction defects correction, drug delivery and ocular muscle surgery. Eye movement recording supports for accurate diagnosis, for patient follow-up and for therapy evaluation. In general, CN patients show a considerable decrease of visual acuity (image fixation on the retina is obstructed by nystagmus continuous oscillations) and severe postural alterations such as the anomalous head position, searched by patient to obtain a better fixation of the target image onto the retina. Often CN presents ‘neutral zones’ corresponding to particular gaze angles, in which nystagmus amplitude minimizes allowing a longer foveation time and a more stable repositioning of foveations, increasing visual acuity. Selected patients’ eye movements were recorded by using EOG or infrared oculography devices. Visual stimulation was delivered by means of an arched LED bar covering a visual field of –30 +30 degrees with respect to the central position. Computation of CN concise parameters allows in-dept analysis of foveations and estimation of visual acuity at different gaze angles. Preliminary results show a maximum of visual acuity at a specific gaze angle; this angle is mostly located at the patient’s right side for the analyzed group.

Beside other Clinical Engineering activities to reduce risks in hospitals, functional assessment of medical devices is becoming more and more extended. Once evaluated the common risk such those electric and mechanical, specific risk are connected to the device performance: functional assessment aims to verify the specific proper operations of a medical apparatus. In particular, neonatal incubators have the primary aim to maintain an adequate microclimate for the newborn, especially those premature and smaller, who may not be able to regulates body temperature. To prevent newborn heat loss, incubator mainly stabilizes the temperature of the baby compartment to a selected value, reducing the risk of hypothermia. As suggested by the Particular Standards for safety of baby incubators, temperature have to be measured in 5 specific points inside infant chamber: the difference between measured temperatures and that selected on incubator must be limited to fractions of °C. Also the time needed to reach a given temperature must be limited. Other tests should be performed to verify humidity, air velocity, noise level, CO2 concentration, etc.. A prototype device was developed to automatically perform functional assessment of neonatal incubators. A microcontroller continuously performs a 12-bit analog to digital conversion of voltage signals generated by 5 thermal probes and a humidity sensor and sends those data to a PC, where a software process received signal and provide tests. The HW device is of little dimensions, battery powered and capable to continuously transmit data wirelessly, the SW allows real-time signal display, average values, optic and acoustic alarms for limits exceeding, data storage, etc. The device can be easily used to perform periodical functional tests on neonatal incubators. Further analysis of recorded data can be used to evaluate more specific features such as modalities of temperature control, etc.