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Published in Jamie Bartram, Rachel Baum, Peter A. Coclanis, David M. Gute, David Kay, Stéphanie McFadyen, Katherine Pond, William Robertson, Michael J. Rouse, Routledge Handbook of Water and Health, 2015
Saxitoxins comprise a group of related carbamate alkaloids including non-sulphated (saxitoxin/neosaxitoxin), single sulphated (gonyautoxins) and double sulphated (C1 and C2 toxins) variants referred to as paralytic shellfish poisons (PSPs). PSPs are part of a larger group of associated shellfish-related poisons. These toxins occur during blooms of eukaryotic (dinoflagellate) algae – so called ‘red tide’ events – in marine coastal regions that are responsible for seasonal closures of shellfish harvesting. Specifically, the dinoflagellate algae Alexandrium fundyense produces saxitoxin, but other species can produce different toxic compounds (e.g. Karenia brevis produces brevetoxin, as known as neurotoxic shellfish poison; the diatom Pseudonitzschia, produces domoic acid, as known as amnesic shellfish poison). Interestingly, within freshwaters these PSPs are produced by several cyanobacteria including Aphanizomenon, Dolichospermum, Lyngbya and Cylindrospermopsis (Table 9.1) and not eukaryotic algae. Saxitoxin inhibits nerve impulse propagation along axons by blocking sodium ion entry into nerve cells through sodium channels. This effectively suppresses stimulation of muscles. Mild PSP intoxication causes slight tingling and numbness of the lips. With higher doses, tingling and numbness moves to the extremities, leading to loss of control and flaccid paralysis, leaving the affected individuals calm and conscious through the progression of symptoms. Like other cyanobacterial neurotoxins, death from respiratory arrest can occur. Saxitoxin is water-soluble and heat-stable (boiling water and cooking won’t destroy it) and like anatoxin-a(s) is more persistent in acidic environments compared to alkaline environments. Reported half-lives for saxitoxin vary from 9 to 28 days and closely related gonyautoxins may persist beyond three months in natural waters (Jones and Negri, 1997). Commercial standards of saxitoxin are available and screening tests and quantitative analyses of water and food are common.
Review of ankle rehabilitation devices for treatment of equinus contracture
Published in Expert Review of Medical Devices, 2022
Kamila Dostalova, Radek Tomasek, Martina Kalova, Miroslav Janura, Jiri Rosicky, Marek Schnitzer, Jiri Demel
Furusho et al. [62] developed a device that assists patients with foot drop and prevents it from occurring during the swing phase, as well as preventing foot slapping during heel contact. A magneto-rheological (MR) brake generates braking torque to maintain dorsiflexion, thus ensuring toe clearance of the user foot during the swing phase and absorbing shock during heel contact. Control is provided by a potentiometer (measuring the ankle angle), a force sensor, and a moment sensor (for ground reaction forces (GRF), calculating the bending moment around the ankle and detecting the timing for MR brake actuation). This AFO weighs 1.6 kg. Clinical test was performed on one patient with right ankle flaccid paralysis where drop foot in swing phase and slap foot at heel strike were prevented
An Automatic Rehabilitation Assessment System for Hand Function Based on Leap Motion and Ensemble Learning
Published in Cybernetics and Systems, 2020
Chenguang Li, Long Cheng, Hongjun Yang, Yongxiang Zou, Fubiao Huang
Brunnstrom technique was developed by Swedish physiotherapist Signe Brunnstrom in the 1970s as a treatment for movement disorders after central nervous system injury. In his theory, stroke patients are classified into 6 recovery stages (Sawner, LaVigne, and Brunnstrom 1992): Flaccid paralysis period: a stroke patient’s hand muscle is flaccid and the patient cannot perform any action.Combined reaction period: a stroke patient’s hand is spastic and the patient is able to flex and extend his/her hand slightly. The patient is able to lift the wrist a little bit.Common movement period: a stroke patient’s hand is at its maximum muscular tension and the patient can only perform a mono flexion action.Partial separation period: muscular tension disappears. A stroke patient can do some simple flexion and extension actions, however, still cannot perform the tip-to-tip action.Separation period: a stroke patient can do flexion and extension actions sufficiently, and can perform the tip-to-tip action.Pre-recovery period: a stroke patient can do the same as the normal people, however, the action is at a slower pace.
Staged treatment protocol for gait with hybrid assistive limb in the acute phase of patients with stroke
Published in Assistive Technology, 2022
Tomoyuki Ueno, Aiki Marushima, Hiroaki Kawamoto, Yukiyo Shimizu, Hiroki Watanabe, Hideki Kadone, Kayo Hiruta, Shunsuke Yamauchi, Ayumu Endo, Yasushi Hada, Hideo Tsurushima, Eiichi Ishikawa, Yuji Matsumaru, Yoshiyuki Sankai, Masashi Yamazaki, Akira Matsumura
The Brunnstrom stage (BRS) is widely used as a standard method to decide on the sequence of the steps of recovery after stroke (Brunnstrom, 1966; Chen et al., 2003). Each step of RPG-HAL was established according to the severity of BRS. In the phase of flaccid paralysis corresponding to BRS I, muscle contraction and bioelectrical signal are used to evaluate whether a patient meets the inclusion criteria to start HAL-Step I. The first detection of muscle contraction corresponds to BRS II, in which extension patterns in the lower limbs can be observed. HAL can be used for a stand-up movement by focusing on assisting the extension of the muscles of hip and knee joints in HAL-Step I. In HAL-Step II, muscle synergy pattern and coordination can be observed, corresponding to BRS III. The goal of HAL-Step II is lifting of the legs forward by flexing the hip and knee joints by involuntary movement assisted by HAL, and the lower limb function improves to BRS IV with a cooperative flexor muscle pattern. In the HAL-Step III, separate movements of hip joint flexion and knee joint extension are observed. In particular, movements aimed at extending the knee joints by flexing the hip joints and a kick out in the terminal swing are emphasized. The assist level of hip joint flexion should be reduced, to increase assists in the extending direction for knee joints. The lower limb function improves to BRS V. In the final program of HAL-Step IV, we focus on assisting the movement in the extending direction of the hip joints, aiming at a gait with a long stride. The gradual reduction of the assist level of the HAL setting allows restoration of a completely independent gait and the lower limb function improves to BRS VI.