Manipulative therapy refers to a manual physical therapy approach performedby a Judo therapist to treat muscle or joint injuries. Evaluation of manipulative therapy outcome in patients typically involves an assessment of the range of motion of the target joint anda measurement of subjective pain relief through an interview or using the visual analog scale (VAS) . However, this approach for pain relief assessment has the limitations of being less objective and problematic if the patient has difficulty communicating with the therapist. To address this concern, we used functional near-infraredspectroscopy (fNIRS) analysis of prefrontal activity to evaluate changes in pain intensity before andafter manipulative therapy. Participant was placedon a treatment table in a supine position with the knees kept straight, and fNIRS probes were attachedto bilateral prefrontal areas, in which the pain-inducedcognitive response occurs. The participant's right leg was kept straight andinflectedtowardthe trunk to the extent that the participant experienceda maximum pain level. At this time, the maximum hip joint flexion angle andthe VAS score were determinedas pre- therapy baseline response. The participant then receivedmanipulative therapy for 5 minutes, andthe right leg was inflectedagain to the same hip joint angle determinedat baseline and VAS score was obtained (post-therapy 1) . The participant's right leg was further inflectedto the extent that the participant experienceda maximum pain level, andthe maximum hip joint angle and VAS score were again determined (post-therapy 2) . Both the VAS score andthe prefrontal hemodynamic activity showed significant decreases after the manipulative therapy (baseline vs. post-therapy 1) suggesting that the therapy increasedthe range of joint motion, andless pain was experiencedat the same joint angle. The maximum inflection of the right leg significantly increasedthe maximum hip joint flexion angle (baseline vs. post-therapy 2). These results suggest that prefrontal hemodynamic activity can be used for objective measurement of pain intensity, andmay be applicable to quantitatively evaluate the effect of manipulative therapy.
Partaking in physical exercise while listening to one's favorite music ameliorates the perception of dyspnea and fatigue and increases one's enjoyment of the exercise. Hence, the use of specific music in a physical training class for elderly people could increase the endurance of the participants. Additionally, this could benefit elderly individuals by reducing frailty and improving cognitive function. However, it may be difficult to elicit information pertaining to preferred music as it may be difficult to communicate with elderly individuals owing to cognitive decline. Thus, in this study, an objective classification method of music preferences was developed using the changes in prefrontal hemodynamic signals while listening to music, measured by functional near-infrared spectroscopy (fNIRS). The experiment consisted of 17 young adults and 17 elderly individuals. While listening to 6 popular songs during different time periods, fNIRS was used to scan the prefrontal brain activity of the subjects. For each song, seventeen features of the fNIRS waveform were extracted, which included statistics of temporal distribution and laterality of changes in oxy-hemoglobin, deoxy-hemoglobin, and total hemoglobin concentrations. From these features, three that exhibited the highest correlation to score of a subjective preference scale obtained from a questionnaire completed by each participant were selected. The extracted features were used to train a 2-class linear classifier that determined whether the listener preferred each song. Mean classification accuracy was calculated by a leave-one-out cross-validation method. The proposed algorithm had mean classification accuracy of 86.3 ± 11.8% and 88.9 ± 14.5% (mean ± standard deviation) in detecting individual favorite songs in young adults and elderly individuals, respectively. The mean classification accuracy was significantly higher when features selected for individual participants were used compared to when fixed and common features for all participants were used. This finding suggested that listening to favorite songs evoked individual changes in emotional responses.
The intravascular membrane oxygenator (IVOX) is placed into the vena cava via a catheter, without housing or perfusion device, and is anticipated to be used during transportation in ambulance and other emergency settings. For intravascular placement of the IVOX, there are some difficulties in ensuring efficient blood flow over the hollow fiber membrane, thus hampering adequate gas exchange. In this study, we sought to improve the gas exchange performance of the IVOX by introducing a blood flow induction conduit inside the hollow fiber membrane bundles. We designed the appropriate shape and placement of the conduit using computational fluid dynamics analysis. We then constructed a model based on the experimental design and evaluated the model in vitro to examine the oxygen and carbon dioxide transfer rates as well as pressure drop. Our results showed that the mean blood velocity in the hollow fiber membrane bundles was lower for the newly designed model than that for a conventional model without the induction conduit, and we confirmed an 80% improvement over the conventional model in terms of the volumes of oxygen and carbon dioxide flow at a blood flow of 3L/min.
Evaluation of the cell culture process in activated autologous lymphocyte therapy is conducted by microscopic observation, and is entrusted to cell culture engineers. Because of the changes in medium permeation rate, color phase of medium, and cell shape and size during the course of culture, culture engineers must subjectively determine the optimal brightness and focus position when capturing cell images. In this study, an objective image capturing method was developed for bag culture of lymphocytes. Images of single cells and cell aggregates were captured at different levels of LED brightness, which was varied by changing the LED current. The color model used for the cell images was converted to the HSL color model (H:hue; S:saturation; L:lightness). The LED brightness was optimized automatically using the index(I)=(255-L)×(L+S), and the focus position was selected to correspond to the position where the maximum number of particles was calculated for each cell image. In conclusion, using our image capturing method, it was possible to objectively capture cell images in bag culture of lymphocytes.
This paper describes local specific absorption rate (SAR) and temperature elevation estimation in a human head model implanted with wireless power transfer technology (WPT) -based vision prosthesis system, as an example of the medical application of WPT and the safety issue of WPT-related electromagnetic field (EMF). A high-resolution numerical model of a human head and an internally implanted vision prosthesis component including WPT coil was constructed. Using finite-difference time-domain analysis, the electromagnetic field distribution inside the human head was calculated and exposure levels to ensure human safety were obtained. Implantable medical devices such as implantable pacemakers and capsule endoscopes are an important application of WPT. Traditionally, these devices use rechargeable or disposable batteries that constitute a source of constraints including large device size and limited operation life. WPT is now considered a key solution to these problems. WPT-based implantable devices are expected to offer patients better mobility and improved quality of life. Using inductive coupling to link the external power source to the implanted device is a sensible choice when considering short-range wireless power transfer for biomedical implants. However, EMF emitted by wireless devices is a subject in the radio radiation protection guidelines on human exposure to EMF. In Japan, Radio Radiation Protection Guidelines for Human Exposure to Electromagnetic Fields has been published. However, these guidelines provide no quantitative discussions about their relevance in patients with WPT-based active implantable devices. It is very important to estimate the amount and nature of EMF that users are likely to be exposed. Given the progress in biomedical technologies, the number of such users will rapidly increase in the near future. Based on precise numerical simulation, we showed that the estimated SAR and temperature elevation in the human head model implanted with a WPT-based vision prosthesis system were within the safety limits described in the guidelines.
The number of patients with internet addiction disorder (IAD), especially among school-age children, is on the rise. Development of objective examination technique to assist the current diagnostic methods using medical interview and inquiry tests is desirable for detection of IAD at its early stage. In this study, we extracted the values of functional connectivity (FC) that correlated with a tendency of IAD, using resting-state functional magnetic resonance imaging (rs-fMRI) data. We recruited 40 males [mean age (SD): 21.9 (0.9) years] with no neurological disorders, conducted rs-fMRI recordings for 7 min 30 s, and administered five questionnaires including internet addiction test (IAT), to assess their mental states. The IAT scores of all participants were in the range of healthy to a tendency of IAD. The FC values were calculated using the cross-correlation of time-series signals in a low frequency band (0.017 to 0.09Hz) between all possible connections of brain region pairs defined by Automated Anatomical Labeling (AAL). For each region pair, we calculated Pearson's correlation coefficients “γ” between the FC values and the scores of IAT as well as other inventories for psychological states, in all subjects. The “γ” were subjects-cross-validated, and the FC of the survived region pairs were statistically assessed by correction of multiple comparison. Finally, we obtained some region pairs in which FC specifically correlated with the IAT scores, but not with other psychological scores. These pairs had mostly negative “γ” over long-distance connections across right and left brain hemispheres. The results suggested that the functional connectivity between specific brain regions was significantly degraded already at the stage prior to the onset of IAD. We expect that our connectivity method can be an objective tool for detecting a tendency of IAD to assist the present diagnostic methods.
Personal Health Records (PHRs), a system that enables people to manage, share, and apply personal healthcare data using information and communication technology, is expected to be an effective method to realize a vigorous society with longevity. However, it is not clear how the user's opt-in agreement and self-management of personal data may be achieved. Thus, we developed a new method to optimize opt-in agreement and access control for users in a PHR developed at Chiba University, the Social Health Assist Chiba (SHACHI). In SHACHI, participating facilities such as hospitals, clinics, pharmacies, and nursing care services display a user's unique two-dimensional bar code on a web browser. The user reads the bar code by him/herself using the “SHACHI App,” which is installed on his/her smart phone beforehand. SHACHI considers this process to signify the user's opt-in agreement. Moreover, users can retract or resume this agreement using the SHACHI App at any time. This system enables the users to self-manage personal data in PHRs. The new system satisfies government requirements and the conditions required for PHR presented in a previous study. This new system can be adopted easily by other PHRs. We plan to identify the required functionalities of standard PHRs and secondary utilization of data stored in PHRs which may be managed through the new system.