| 1. |
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| 2. |
- Kehoe, Laura, et al.
(författare)
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Make EU trade with Brazil sustainable
- 2019
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Ingår i: Science. - : American Association for the Advancement of Science (AAAS). - 0036-8075 .- 1095-9203. ; 364:6438, s. 341-
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 3. |
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| 4. |
- Kwakkel, G., et al.
(författare)
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Motor rehabilitation after stroke: European Stroke Organisation (ESO) consensus-based definition and guiding framework
- 2023
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Ingår i: European Stroke Journal. - 2396-9873. ; 8:4, s. 880-894
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Forskningsöversikt (refereegranskat)abstract
- Purpose: To propose a consensus-based definition and framework for motor rehabilitation after stroke. Methods: An expert European working group reviewed the literature, attaining internal consensus after external feedback. Findings: Motor rehabilitation is defined as a process that engages people with stroke to benefit their motor function, activity capacity and performance in daily life. It is necessary for people with residual motor disability whose goal is to enhance their functioning, independence and participation. Motor rehabilitation operates through learning- and use-dependent mechanisms. The trajectory of motor recovery varies across patients and stages of recovery. Early behavioral restitution of motor function depends on spontaneous biological mechanisms. Further improvements in activities of daily living are achieved by compensations. Motor rehabilitation is guided by regular assessment of motor function and activity using consensus-based measures, including patient-reported outcomes. Results are discussed with the patient and their carers to set personal goals. During motor rehabilitation patients learn to optimize and adapt their motor, sensory and cognitive functioning through appropriately dosed repetitive, goal-oriented, progressive, task- and context-specific training. Motor rehabilitation supports people with stroke to maximize health, well-being and quality of life. The framework describes the International Classification of Functioning, Disability and Health in the context of stroke, describes neurobiological mechanisms of behavioral restitution and compensation, and summarizes recommendations for clinical assessment, prediction tools, and motor interventions with strong recommendations from clinical practice guidelines (2016-2022). Conclusions: This definition and framework may guide clinical educators, inform clinicians on current recommendations and guidelines, and identify gaps in the evidence base.
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| 5. |
- Ortiz Catalan, Max Jair, 1982, et al.
(författare)
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A highly integrated bionic hand with neural control and feedback for use in daily life
- 2023
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Ingår i: Science Robotics. - 2470-9476. ; 8:83
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Tidskriftsartikel (refereegranskat)abstract
- Restoration of sensorimotor function after amputation has remained challenging because of the lack of human-machine interfaces that provide reliable control, feedback, and attachment. Here, we present the clinical implementation of a transradial neuromusculoskeletal prosthesis-a bionic hand connected directly to the user's nervous and skeletal systems. In one person with unilateral below-elbow amputation, titanium implants were placed intramedullary in the radius and ulna bones, and electromuscular constructs were created surgically by transferring the severed nerves to free muscle grafts. The native muscles, free muscle grafts, and ulnar nerve were implanted with electrodes. Percutaneous extensions from the titanium implants provided direct skeletal attachment and bidirectional communication between the implanted electrodes and a prosthetic hand. Operation of the bionic hand in daily life resulted in improved prosthetic function, reduced postamputation, and increased quality of life. Sensations elicited via direct neural stimulation were consistently perceived on the phantom hand throughout the study. To date, the patient continues using the prosthesis in daily life. The functionality of conventional artificial limbs is hindered by discomfort and limited and unreliable control. Neuromusculoskeletal interfaces can overcome these hurdles and provide the means for the everyday use of a prosthesis with reliable neural control fixated into the skeleton.
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| 6. |
- Ferro-Vazquez, C., et al.
(författare)
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Metal and organic matter immobilization in temperate podzols : a high resolution study
- 2014
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Ingår i: Geoderma. - : Elsevier. - 0016-7061 .- 1872-6259. ; 217, s. 225-234
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Tidskriftsartikel (refereegranskat)abstract
- Aluminium and Fe fractions were obtained in samples from two temperate podzols by selective extraction with NaOH (Al-n, Fe-n), Na-dithionite-citrate (Al-d, Fe-d), acid NH4-oxalate (Al-o, Fe-o) and Na-pyrophosphate (Al-p, Fe-p) following the traditional fractionation procedures, and also by the use of the chlorides of K (Al-K), La (Al-La) and Cu (Al-cu) as non-buffered extractants for Al. Carbon content was also determined in the Na-pyrophosphate extract (C-p). Soil sampling was done at high-resolution to allow a more detailed characterization of the vertical processes than the traditional sampling by whole soil horizons. Results showed that Al-p and Fe-p make a large proportion of the Alo and Fe-o meaning that organoaluminic complexes dominated in the "active" metal pool instead of inorganic compounds. The degree of metal saturation of soil organic matter (estimated by the (Al-p Fe-p)/C-p molar ratios) increases with depth, especially in the uppermost samples of spodic horizons (Bhs1) where it increases up to 0.1. Aluminium dominates in the adsorption positions of the organic matter in the spodic horizon (Fe-p/Al-p ratios <0.5), except in the Bhs1 horizon (ratios > 1), indicating that the immobilization of Fe containing complexes occurs 10-15 cm above that of Al The highly stable Al-OM complexes accounted on average for 60% of the organoaluminic associations (>70% in the Bhs horizons). The moderately stable complexes predominate in A horizons (57-77% in ACB1 and 37-48% in ACB2) and the largest proportions of low stability complexes were found in the uppermost samples of the spodic horizons (Bhs1) of both soils (9-21%), together with the highest Fep contents and a decrease in pH values. From a stepwise multiple regression model it is suggested that pH is the main variable accounting for the stability of Al-OM compounds together with C and organically bound Fe contents. It is suggested that the illuviation of unsaturated organic acids lower the pH in upper spodic horizons, leading to the complexation of metals from formerly precipitated organometallic complexes and/or leading to their redissolution, enabling their migration to deeper soil layers. Iron complexes would be less soluble at soil pH, resulting in a differentiation of an upper Fe-rich Bhs1 horizon and a lower Bhs2 Al-rich horizon. The depth variation in C accumulation was found to be related to the proportion of highly stable Al-OM fraction.
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| 7. |
- Musolf, Brett M., et al.
(författare)
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Analysis and Design of a Bypass Socket for Transradial Amputations
- 2021
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Ingår i: Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBS. - 1557-170X. ; , s. 4611-4614
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Konferensbidrag (refereegranskat)abstract
- The ability to measure functional performance of a prosthesis is hindered by the lack of an equalized mechanical platform to test from. Researchers and designers seeking to increase the pace of development have attempted novel mounts for prostheses so these can be used by able-bodied participants. Termed bypass sockets, these can increase the sampling pool during prosthetic evaluations. Here, we present an open-source, 3D printable prosthetic bypass socket for below-elbow (transradial) amputations. Methods to quantify the effectiveness of bypass sockets are limited and therefore we propose the use of a validated and clinically relevant evaluation tool, the Assessment of Capacity for Myoelectric Control (ACMC). We performed the ACMC in six able-bodied subjects with limited experience with myoelectric prostheses and found the participants to be rated from non- to somewhat capable using the ACMC interpretation scale. In addition, we conducted a secondary evaluation consisting of a subset of tasks of the Cybathlon competition aimed at eliciting fatigue in the participants. All participants completed said tasks, suggesting that the bypass socket is suitable for extended use during prosthesis development.Clinical Relevance - The design and validation of the bypass socket presented here can facilitate the development of upper limb prosthetic systems.
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| 8. |
- Zbinden, Jan, 1994, et al.
(författare)
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Improved control of a prosthetic limb by surgically creating electro-neuromuscular constructs with implanted electrodes
- 2023
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Ingår i: Science translational medicine. - 1946-6234 .- 1946-6242. ; 15:704
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Tidskriftsartikel (refereegranskat)abstract
- Remnant muscles in the residual limb after amputation are the most common source of control signals for prosthetic hands, because myoelectric signals can be generated by the user at will. However, for individuals with amputation higher up the arm, such as an above-elbow (transhumeral) amputation, insufficient muscles remain to generate myoelectric signals to enable control of the lost arm and hand joints, thus making intuitive control of wrist and finger prosthetic joints unattainable. We show that severed nerves can be divided along their fascicles and redistributed to concurrently innervate different types of muscle targets, particularly native denervated muscles and nonvascularized free muscle grafts. We engineered these neuromuscular constructs with implanted electrodes that were accessible via a permanent osseointegrated interface, allowing for bidirectional communication with the prosthesis while also providing direct skeletal attachment. We found that the transferred nerves effectively innervated their new targets as shown by a gradual increase in myoelectric signal strength. This allowed for individual flexion and extension of all five fingers of a prosthetic hand by a patient with a transhumeral amputation. Improved prosthetic function in tasks representative of daily life was also observed. This proof-of-concept study indicates that motor neural commands can be increased by creating electro-neuromuscular constructs using distributed nerve transfers to different muscle targets with implanted electrodes, enabling improved control of a limb prosthesis.
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