High-frequency epidural electrical stimulation reduces spasticity and facilitates walking recovery in patients with spinal cord injury.

Spinal cord injury (SCI) causes severe motor and sensory deficits, and there are currently no approved treatments for recovery. Nearly 70% of patients with SCI experience pathological muscle cocontraction and spasticity, accompanied by clinical signs such as patellar hyperreflexia and ankle clonus. The integration of epidural electrical stimulation (EES) of the spinal cord with rehabilitation has substantial potential to improve recovery of motor functions; however, abnormal muscle cocontraction and spasticity may limit the benefit of these interventions and hinder the effectiveness of EES in promoting functional movements.

Wearable Technologies for Monitoring Upper Extremity Functions During Daily Life in Neurologically Impaired Individuals.

Neurological disorders, including stroke, spinal cord injuries, multiple sclerosis, and Parkinson's disease, generally lead to diminished upper extremity (UE) function, impacting individuals' independence and quality of life. Traditional assessments predominantly focus on standardized clinical tasks, offering limited insights into real-life UE performance. In this context, this review focuses on wearable technologies as a promising solution to monitor UE function in neurologically impaired individuals during daily life activities.

FetalBrainAwareNet: Bridging GANs with anatomical insight for fetal ultrasound brain plane synthesis.

Over the past decade, deep-learning (DL) algorithms have become a promising tool to aid clinicians in identifying fetal head standard planes (FHSPs) during ultrasound (US) examination. However, the adoption of these algorithms in clinical settings is still hindered by the lack of large annotated datasets. To overcome this barrier, we introduce FetalBrainAwareNet, an innovative framework designed to synthesize anatomically accurate images of FHSPs.

Immersive VR for upper-extremity rehabilitation in patients with neurological disorders: a scoping review.

Background: Neurological disorders, such as stroke and chronic pain syndromes, profoundly impact independence and quality of life, especially when affecting upper extremity (UE) function. While conventional physical therapy has shown effectiveness in providing some neural recovery in affected individuals, there remains a need for improved interventions. Virtual reality (VR) has emerged as a promising technology-based approach for neurorehabilitation to make the patient's experience more enjoyable.

Designing an Egocentric Video-Based Dashboard to Report Hand Performance Measures for Outpatient Rehabilitation of Cervical Spinal Cord Injury.

Background: Functional use of the upper extremities (UEs) is a top recovery priority for individuals with cervical spinal cord injury (cSCI), but the inability to monitor recovery at home and limitations in hand function outcome measures impede optimal recovery.

Objectives: We developed a framework using wearable cameras to monitor hand use at home and aimed to identify the best way to report information to clinicians.

Methods: A dashboard was iteratively developed with clinician ( = 7) input through focus groups and interviews, creating low-fidelity prototypes based on recurring feedback until no new information emerged.

A preliminary study on self-care telemonitoring of dysarthria in spinal muscular atrophy.

Spinal muscular atrophy (SMA) is a rare neuromuscular disease which may cause impairments in oro-facial musculature. Most of the individuals with SMA present bulbar signs such as flaccid dysarthria which mines their abilities to speak and, as consequence, their psychic balance. To support clinicians, recent work has demonstrated the feasibility of video-based techniques for assessing the oro-facial functions in patients with neurological disorders such as amyotrophic lateral sclerosis.

Exploiting class activation mappings as prior to generate fetal brain ultrasound images with GANs.

The identification of fetal-head standard planes (FHSPs) from ultrasound (US) images is of fundamental importance to visualize cerebral structures and diagnose neural anomalies during gestation in a standardized way. To support the activity of healthcare operators, deep-learning algorithms have been proposed to classify these planes. To date, the translation of such algorithms in clinical practice is hampered by several factors, including the lack of large annotated datasets to train robust and generalizable algorithms.

Classification of patients with cardiac amyloidosis using machine learning models on Italian electronic clinical health records.

Amyloidosis refers to a range of medical conditions in which misshapen proteins accumulate in various organs and tissues, forming insoluble fibrils. Cardiac amyloidosis is frequently linked to the buildup of misfolded transthyretin (TTR) or immunoglobulin light chains (AL). Delayed diagnosis, due to lack of disease awareness, results in a poor prognosis, especially in patients with AL amyloidosis.

Neurophysiological underpinnings of an intensive protocol for upper limb motor recovery in subacute and chronic stroke patients.

Background: Upper limb (UL) motor impairment following stroke is a leading cause of functional limitations in activities of daily living. Robot-assisted therapy supports rehabilitation, but how its efficacy and the underlying neural mechanisms depend on the time after stroke is yet to be assessed.

Aim: We investigated the response to an intensive protocol of robot-assisted rehabilitation in sub-acute and chronic stroke patients, by analyzing the underlying changes in clinical scores, electroencephalography (EEG) and end-effector kinematics.

Intelligibility of speech in Parkinson's disease relies on anatomically segregated subthalamic beta oscillations.

Background: Speech impairment is commonly reported in Parkinson's disease and is not consistently improved by available therapies - including deep brain stimulation of the subthalamic nucleus (STN-DBS), which can worsen communication performance in some patients. Improving the outcome of STN-DBS on speech is difficult due to our incomplete understanding of the contribution of the STN to fluent speaking.

Objective: To assess the relationship between subthalamic neural activity and speech production and intelligibility.

Grasp Analysis in the Home Environment as a Measure of Hand Function After Cervical Spinal Cord Injury.

Background: Following a spinal cord injury, regaining hand function is a top priority. Current hand assessments are conducted in clinics, which may not fully represent real-world hand function. Grasp strategies used in the home environment are an important consideration when examining the impact of rehabilitation interventions.

Left Atrioventricular Transvalvular Pressure Gradients Derived from Intraoperative and Postoperative Echocardiograms following Atrioventricular Septal Defect Repair.

Background: Left atrioventricular valve (LAVV) stenosis following an atrioventricular septal defect (AVSD) repair is a rare but potentially life-threatening complication. While echocardiographic quantification of diastolic transvalvular pressure gradients is paramount in the evaluation of a newly corrected valve function, it is hypothesized that these measured gradients are overestimated immediately following a cardiopulmonary bypass (CPB) due to the altered hemodynamics when compared to postoperative valve assessments using awake transthoracic echocardiography (TTE) upon recovery after surgery.

Methods: Out of the 72 patients screened for inclusion at a tertiary center, 39 patients undergoing an AVSD repair with both intraoperative transesophageal echocardiograms (TEE, performed immediately after a CPB) and an awake TTE (performed prior to hospital discharge) were retrospectively selected.

Bolus Texture Testing as a Clinical Method for Evaluating Food Oral Processing and Choking Risk: A Pilot Study.

Purpose: Choking on food is a leading cause of accidental death in several populations, including children, people with intellectual/developmental disability, and older adults in residential care facilities. One contributor to choking risk is incomplete oral processing and failure to convert food to a cohesive, nonsticky bolus with a maximum particle size that will not block the airway. Clinical tests of mastication do not evaluate properties of chewed food boluses.

Automated pharyngeal phase detection and bolus localization in videofluoroscopic swallowing study: Killing two birds with one stone?

Background And Objective: The videofluoroscopic swallowing study (VFSS) is a gold-standard imaging technique for assessing swallowing, but analysis and rating of VFSS recordings is time consuming and requires specialized training and expertise. Researchers have recently demonstrated that it is possible to automatically detect the pharyngeal phase of swallowing and to localize the bolus in VFSS recordings via computer vision approaches, fostering the development of novel techniques for automatic VFSS analysis. However, training of algorithms to perform these tasks requires large amounts of annotated data that are seldom available.

Measuring Hand Use in the Home after Cervical Spinal Cord Injury Using Egocentric Video.

Egocentric video has recently emerged as a potential solution for monitoring hand function in individuals living with tetraplegia in the community, especially for its ability to detect functional use in the home environment. The aim of this study was to develop and validate a wearable vision-based system for measuring hand use in the home among individuals living with tetraplegia. Several deep learning algorithms for detecting functional hand-object interactions were developed and compared.

Protective continuous ventilation strategy during cardiopulmonary bypass in children undergoing surgery for congenital heart disease: a prospective study.

Objectives: The aim of this study was to evaluate if a 'protective' (low-tidal/low-frequency) ventilation strategy can shorten the postoperative ventilation time and minimize acute lung injury in children with congenital heart disease (CHD) undergoing repair with cardiopulmonary bypass (CPB).

Methods: This is a single-centre prospective, interventional study, including children with CHD under the age of 5 years, undergoing open-heart surgery with a CPB >60 min, in hypothermia, haemodynamically stable, and without evident genetic abnormalities. Assist-control ventilation (tidal volume of 4 ml/kg, 10 breaths/min, positive end-expiratory pressure 5 cmH2O and FiO2 0.

Post-Stroke Hemiplegic Rodent Evaluation: A Framework for Assessing Forelimb Movement Quality Using Kinematics.

Kinematics is the gold-standard method for measuring detailed joint motions. Recent research demonstrates that post-stroke kinematic analysis in rats reveals reaching abnormalities similar to those seen in humans after stroke. Nonetheless, behavioral neuroscientists have failed to incorporate kinematic methods for assessing movement quality in stroke models.

The effect of time on the automated detection of the pharyngeal phase in videofluoroscopic swallowing studies.

Convolutional Neural Networks (CNNs) have recently been proposed to automatically detect the pharyngeal phase in videofluoroscopic swallowing studies (VFSS). However, there is a lack of consensus regarding the best algorithmic strategy to adopt for segmenting this important yet rapid phase of the swallow. Moreover, additional information is needed to understand how small the detection error should be, in view of translating this approach for use in clinical practice.

Perspectives and recommendations of individuals with tetraplegia regarding wearable cameras for monitoring hand function at home: Insights from a community-based study.

Context: Wearable cameras have great potential for producing novel outcome measures of upper limb (UL) function and guiding care in individuals with cervical spinal cord injury (cSCI) living in the community. However, little is known about the perspectives of individuals with cSCI on the potential adoption of this technology.

Objective: To analyze feedback from individuals with cSCI regarding the use of wearable cameras to record daily activities at home, in order to define guidelines for improving the design of this technology and fostering its implementation to optimize UL rehabilitation.

Capturing Representative Hand Use at Home Using Egocentric Video in Individuals with Upper Limb Impairment.

Impaired hand function after neurological injuries can have a major impact on independence and quality of life. Most existing upper limb assessments are carried out in person, which is not always indicative of hand use in the community. Novel approaches to capture hand function in daily life are required to measure the true impact of rehabilitation interventions.

A wearable vision-based system for detecting hand-object interactions in individuals with cervical spinal cord injury: First results in the home environment.

Cervical spinal cord injury (cSCI) causes the paralysis of upper and lower limbs and trunk, significantly reducing quality of life and community participation of the affected individuals. The functional use of the upper limbs is the top recovery priority of people with cSCI and wearable vision-based systems have recently been proposed to extract objective outcome measures that reflect hand function in a natural context. However, previous studies were conducted in a controlled environment and may not be indicative of the actual hand use of people with cSCI living in the community.

Stress Assessment by Combining Neurophysiological Signals and Radio Communications of Air Traffic Controllers.

Air Traffic Control (ATC) has been classified as the fourth most stressful job. In this regard, sixteen controllers were asked to perform ecological ATC simulation during which behavioral (Radio Communications with pilots - RCs), subjective (stress perception) and neurophysiological signals (brain activity and skin conductance - SC) were collected. All the considered parameters reported significant changes under high stress conditions.

A New Dataset for Facial Motion Analysis in Individuals With Neurological Disorders.

We present the first public dataset with videos of oro-facial gestures performed by individuals with oro-facial impairment due to neurological disorders, such as amyotrophic lateral sclerosis (ALS) and stroke. Perceptual clinical scores from trained clinicians are provided as metadata. Manual annotation of facial landmarks is also provided for a subset of over 3300 frames.

Analysis of the Hands in Egocentric Vision: A Survey.

Egocentric vision (a.k.a.

Automatic prediction of intelligible speaking rate for individuals with ALS from speech acoustic and articulatory samples.

: This research aimed to automatically predict intelligible speaking rate for individuals with Amyotrophic Lateral Sclerosis (ALS) based on speech acoustic and articulatory samples. Twelve participants with ALS and two normal subjects produced a total of 1831 phrases. NDI Wave system was used to collect tongue and lip movement and acoustic data synchronously.