Quantitative Assessment of Clinician Assistance During Dynamic Rehabilitation Using Force Sensitive Resistors

Background: Neuromodulation using epidural electrical stimulation (EES) has shown functional restoration in humans with chronic spinal cord injury (SCI). EES during body weight supported treadmill training (BWSTT) enhanced stepping performance in clinical trial participants with paraplegia. Unfortunately, tools are lacking in availability to quantify clinician assistance during BWSTT with and without EES. Force sensitive resistors (FSRs) have previously quantified clinician assistance during static standing; however, dynamic tasks have not been addressed.Objective: To determine the validity of FSRs in measurements of force and duration to quantify clinician assistance and participant progression during BWSTT with EES in participants with SCI.Design: A feasibility study to determine the effectiveness of EES to restore function in individuals with SCI.Methods: Two male participants with chronic SCI were enrolled in a pilot phase clinical trial. Following implantation of an EES system in the lumbosacral spinal cord, both participants underwent 12 months of BWSTT with EES. At monthly intervals, FSRs were positioned on participants' knees to quantity forces applied by clinicians to achieve appropriate mechanics of stepping during BWSTT. The FSRs were validated on the benchtop using a leg model instrumented with a multiaxial load cell as the gold standard. The outcomes included clinician-applied force duration measured by FSR sensors and changes in applied forces indicating progression over the course of rehabilitation.Results: The force sensitive resistors validation revealed a proportional bias in their output. Loading required for maximal assist training exceeded the active range of the FSRs but were capable of capturing changes in clinician assist levels. The FSRs were also temporally responsive which increased utility for accurately assessing training contact time. The FSRs readings were able to capture independent stance for both participants by study end. There was minimal to no applied force bilaterally for participant 1 and unilaterally for participant 2.Conclusions: Clinician assistance applied at the knees as measured through FSRs during dynamic rehabilitation and EES (both on and off) effectively detected point of contact and duration of forces; however, it lacks accuracy of magnitude assessment. The reduced contact time measured through FSRs related to increased stance duration, which objectively identified independence in stepping during EES-enabled BWSTT following SCI.

Analysis of meteorological parameters triggering rainfall- induced landslide: a review of 70 years in Valtellina

This paper presents an extended reanalysis of the rainfall-induced geo-hydrological events that have occurred in the last 70 years in the alpine area of the Lombardy region, Italy. The work is focused on the description of the major meteorological triggering factors that have caused diffuse episodes of shallow landslides and debris flow. The aim of this reanalysis was to try to evaluate their magnitude quantitatively. The triggering factors were studied following two approaches. The first one started from the conventional analysis of the rainfall intensity (I) and duration (D) considering local rain gauge data and applying the I–D threshold methodology integrated with an estimation of the events' return period. We then extended this analysis and proposed a new index for the magnitude assessment (magnitude index, MI) based on frequency–magnitude theory. The MI was defined considering both the return period and the spatial extent of each rainfall episode. The second approach is based on a regional-scale analysis of meteorological triggers. In particular, the strength of the extratropical cyclone (EC) structure associated with the precipitation events was assessed through the sea level pressure tendency (SLPT) meteorological index. The latter has been estimated from the Norwegian cyclone model (NCM) theory. Both indexes have shown an agreement in ranking the event's magnitude (R2=0.88), giving a similar interpretation of the severity that was also found to be in accordance with the information reported in historical databases. This back analysis of 70 years in Valtellina identifies the MI and the SLPT as good magnitude indicators of the event, confirming that a strong cause–effect relationship exists among the EC intensity and the local rainfall recorded on the ground. In respect of the conventional I–D threshold methodology, which is limited to a binary estimate of the likelihood of landslide occurrence, the evaluation of the MI and the SLPT indexes allows quantifying the magnitude of a rainfall episode capable of generating severe geo-hydrological hazards.

Absence of history of oral cleft in first-degree relatives of patients with prostate cancer

Objective: To evaluate the occurrence of nonsyndromic cleft lip and/or palate (NSCL/P) in families of patients with prostate cancer (PC).Study design: We conducted a case-control study involving a total of 748 individuals, 280 of which had PC, and 468 were free-cancer healthy individuals. The patients answered a questionnaire with basic demographic information and family history of NSCL/P in first-degree relatives. The information collected was stored in a database and analyzed by using the statistical program SPSS® 24.0 for Windows (Chicago, IL, USA). In order to determine the association with NSCL/P, chi-square and Fisher’s exact test and odds ratio (OR) with its 95% confidence interval (95% CI) for risk magnitude assessment. Values with p<0.05 were considered statistically significant.Results: Of total patients with PC, 2 had a positive history of NSCL/P. In the control group, 7 patients reported family history of NSCL/P (1df chi-square, p=0.34; Fisher´s exact test, p=0.49). The average age of the cases diagnosed with PC was 71.35±7.70 years, and control group was 64.42±9.67 years.Conclusion: Despite the limited population, the frequency of NSCL/P was not significantly increased in the first-degree relatives of patients with PC. Studies with larger samples and molecular analyses are needed to better understand the possible relationships in the etiology of cancer and NSCL/P.

Sentinel-1 SAR Amplitude Imagery for Rapid Landslide Detection

Despite landslides impact the society worldwide every day, landslide information is inhomogeneous and lacking. When landslides occur in remote areas or where the availability of optical images is rare due to cloud persistence, they might remain unknown, or unnoticed for long time, preventing studies and hampering civil protection operations. The unprecedented availability of SAR C-band images provided by the Sentinel-1 constellation offers the opportunity to propose new solutions to detect landslides events. In this work, we perform a systematic assessment of Sentinel-1 SAR C-band images acquired before and after known events. We present the results of a pilot study on 32 worldwide cases of rapid landslides entailing different types, sizes, slope expositions, as well as pre-existing land cover, triggering factors and climatic regimes. Results show that in about eighty-four percent of the cases, changes caused by landslides on SAR amplitudes are unambiguous, whereas only in about thirteen percent of the cases there is no evidence. On the other hand, the signal does not allow for a systematic use to produce inventories because only in 8 cases, a delineation of the landslide borders (i.e., mapping) can be manually attempted. In a few cases, cascade multi-hazard (e.g., floods caused by landslides) and evidences of extreme triggering factors (e.g., strong earthquakes or very rapid snow melting) were detected. The method promises to increase the availability of information on landslides at different spatial and temporal scales with benefits for event magnitude assessment during weather-related emergencies, model tuning, and landslide forecast model validation, in particular when accurate mapping is not required.

Quantitative Deterioration Assessment of Road Bridge Decks Based on Site Inspected Cracks

By integrating a multi-scale simulation with the pseudo-cracking method, the remaining fatigue life of in-service reinforced concrete (RC) bridge decks can be estimated based upon their site-inspected crack patterns. But, it still takes time for computation. In order to achieve a quick deterioration-magnitude assessment of RC decks based upon their crack patterns, two evaluation methods are proposed. A predictive correlation between the remaining fatigue life and the cracks density (both cracks length and width) is presented as a fast judgment. For fair-detailed judgment, an artificial neural network (ANN) model is also introduced which is the basis of the machine learning. Both assessment methods are built commonly by thousands of artificial random crack patterns to cover all possible ranges since the variety of the real crack patterns on site is more or less limited. The built ANN performances are examined by k-fold cross-validation besides checking the prediction accuracy of real crack patterns of bridge RC decks. Finally, the hazard map of the deck’s bottom surface is introduced to indicate the location of higher risk cracking, which derives from the estimated weight of individual neuron in the built artificial neural network.