Can a powered knee-ankle prosthesis improve weight-bearing symmetry during stand-to-sit transitions in individuals with above-knee amputations?

Background: After above-knee amputation, the missing biological knee and ankle are replaced with passive prosthetic devices. Passive prostheses are able to dissipate limited amounts of energy using resistive damper systems during "negative energy" tasks like sit-down. However, passive prosthetic knees are not able to provide high levels of resistance at the end of the sit-down movement when the knee is flexed, and users need the most support.

Suvorexant, a Novel Dual Orexin Receptor Antagonist, for the Management of Insomnia.

Purpose Of Review: The present investigation is a comprehensive review regarding the use of Suvorexant for insomnia treatment. It covers the background, pathophysiology, and significance of addressing insomnia, the pharmaceutical details of Suvorexant, and its safety, efficacy, and implications in treating insomnia. We further discuss Suvorexant's role in targeting insomnia with other comorbidities.

Selective Serotonin Reuptake Inhibitors and Associated Bleeding Risks: A Narrative and Clinical Review.

Major Depressive Disorder (MDD) is a major cause of disability worldwide and is associated with serious lasting impairment. A leading hypothesis of the pathophysiology of MDD is the monoamine deficiency hypothesis which suggests that depression is caused by depletion of serotonin, norepinephrine, or dopamine in the central nervous system. Serotonin is the most widely studied neurotransmitter in the pathophysiology of depression, with studies showing that reduced central serotonin synthesis leads to depressive symptoms in individuals at risk for depression.

Effect of Increasing Assistance From a Powered Prosthesis on Weight-Bearing Symmetry, Effort, and Speed During Stand-Up in Individuals With Above-Knee Amputation.

After above-knee amputation, the missing biological knee and ankle are commonly replaced with a passive prosthesis, which cannot provide net-positive energy to assist the user. During activities such as sit-to-stand, above-knee amputees must compensate for this lack of power using their upper body, intact limb, and residual limb, resulting in slower, less symmetric, and higher effort movements. Previous studies have shown that powered prostheses can improve symmetry and speed by providing positive assistive power.

Intrinsic factors contributing to elevated intra-abdominal pressure.

Pelvic floor disorders affect 24% of US women, and elevated intra-abdominal pressure may cause pelvic injury through musculoskeletal strain. Activity restrictions meant to reduce pelvic strain after traumatic events, such as childbirth, have shown little benefit to patients. Reported high variability in abdominal pressure suggests that technique plays a substantial role in pressure generation.

The impact of ankle-foot orthosis's plantarflexion resistance on knee adduction moment in people with chronic stroke.

Background: An ankle-foot orthosis (AFO) is used to assist gait of people with chronic stroke. It is widely accepted that AFO's plantarflexion resistance affects sagittal knee moments during their gait. However, its effect on the coronal knee moment remains unclear.

Stand-Up, Squat, Lunge, and Walk With a Robotic Knee and Ankle Prosthesis Under Shared Neural Control.

Emerging robotic knee and ankle prostheses present an opportunity to restore the biomechanical function of missing biological legs, which is not possible with conventional passive prostheses. However, challenges in coordinating the robotic prosthesis movements with the user's neuromuscular system and transitioning between activities limit the real-world viability of these devices. Here we show that a shared neural control approach combining neural signals from the user's residual limb with robot control improves functional mobility in individuals with above-knee amputation.

Robust Torque Predictions From Electromyography Across Multiple Levels of Active Exoskeleton Assistance Despite Non-linear Reorganization of Locomotor Output.

Robotic exoskeletons can assist humans with walking by providing supplemental torque in proportion to the user's joint torque. Electromyographic (EMG) control algorithms can estimate a user's joint torque directly using real-time EMG recordings from the muscles that generate the torque. However, EMG signals change as a result of supplemental torque from an exoskeleton, resulting in unreliable estimates of the user's joint torque during active exoskeleton assistance.

Brexanolone, a GABA Modulator, in the Treatment of Postpartum Depression in Adults: A Comprehensive Review.

Postpartum depression (PPD) is one of the three major categories on the spectrum of postpartum psychiatric syndromes. Postpartum psychiatric syndromes are classified as either postpartum blues, postpartum depression, or postpartum psychosis. Postpartum depression is important to recognize clinically because of the effect it can have on the mother-child bond.

Career interests of undergraduate nursing students: A ten-year longitudinal study.

An understanding of students' career interests at entry and exit from undergraduate nursing programmes could inform decisions regarding curricula and clinical placements. Since 2006, the University of Auckland has surveyed healthcare students at entry to and exit from their respective programmes, collecting information on a range of demographic, and career-related factors. This article describes career interests of over 500 undergraduate nursing students in New Zealand over a ten-year period.

Protective stepping in multiple sclerosis: Impacts of a single session of in-place perturbation practice.

Objectives: To evaluate the impact of a single day of protective stepping practice in individuals with Multiple Sclerosis (MS).

Background: Multiple Sclerosis is a leading cause of disability among young adults in the United States. Gait and balance dysfunction are both widespread in MS and strong predictors of falls, disability, and quality of life among those with MS.

The effects of alignment of an articulated ankle-foot orthosis on lower limb joint kinematics and kinetics during gait in individuals post-stroke.

Mechanical tuning of an ankle-foot orthosis (AFO) is important in improving gait in individuals post-stroke. Alignment and resistance are two factors that are tunable in articulated AFOs. The aim of this study was to investigate the effects of changing AFO ankle alignment on lower limb joint kinematics and kinetics with constant dorsiflexion and plantarflexion resistance in individuals post-stroke.

The effects of an articulated ankle-foot orthosis with resistance-adjustable joints on lower limb joint kinematics and kinetics during gait in individuals post-stroke.

Background: Resistance is a key mechanical property of an ankle-foot orthosis that affects gait in individuals post-stroke. Triple Action® joints allow independent adjustment of plantarflexion resistance and dorsiflexion resistance of an ankle-foot orthosis. Therefore, the aim of this study was to investigate the effects of incremental changes in dorsiflexion and plantarflexion resistance of an articulated ankle-foot orthosis with the Triple Action joints on lower limb joint kinematics and kinetics in individuals post-stroke during gait.

Effect of plantarflexion resistance of an ankle-foot orthosis on ankle and knee joint power during gait in individuals post-stroke.

Plantarflexion resistance of an ankle-foot orthosis (AFO) plays an important role to prevent foot-drop, but its impact on push-off has not been well investigated in individuals post-stroke. The aim of this study was to investigate the effect of plantarflexion resistance of an articulated AFO on ankle and knee joint power of the limb wearing the AFO in individuals post-stroke. Gait analysis was performed on 10 individuals with chronic stroke using a Vicon 3-dimensional motion capture system and a Bertec split-belt instrumented treadmill.

An articulated ankle-foot orthosis with adjustable plantarflexion resistance, dorsiflexion resistance and alignment: A pilot study on mechanical properties and effects on stroke hemiparetic gait.

Mechanical properties of an articulated ankle-foot orthosis (AFO) are closely related to gait performance in individuals post-stroke. This paper presents a pilot study on the mechanical properties of a novel articulated AFO with adjustable plantarflexion resistance, dorsiflexion resistance and alignment, and its effect on ankle and knee joint kinematics and kinetics in an individual post-stroke during gait. The mechanical properties of the AFO were quantified.

Five-year results of a randomized trial with open-label extension of triamcinolone acetonide for refractory diabetic macular edema.

Objective: To report 5-year outcomes from a clinical trial of intravitreal triamcinolone acetonide (IVTA) in eyes with diabetic macular edema (DME) and impaired vision despite previous laser treatment.

Design: Prospective, double-masked, randomized clinical trial. After completing the 2-year visit, all eyes, including those initially randomized to receive placebo, received IVTA according to prospectively defined guidelines.

EROSION OF WAXES FROM LEAF SURFACES BY SIMULATED RAIN.

Effects of simulated rain on the epicuticular wax of glaucous leaves have been studied. Droplets (250 to 400 μm) travelling at low or medium velocity (0.25 to 5 m s ) fractured the dendrites and tubes on leaves of Brassica spp.