作者想感谢的Rabih陶氏，帕德玛拉贾格帕兰，莫莉·康纳斯和盲人卡罗尔中心的工作人员（牛顿MA，USA）的支持，在开展这项研究。这项工作是由美国国立卫生研究院/ NEI补助金：RO1 EY019924支持。

1。参与者的人口统计学这是一个持续的研究，招募盲目的年龄在18-45岁之间的男性和女性参加。所有参与者在法律上是盲目的早期发病（记录之前于3岁以下）和不同的眼部病因。这项研究的参与者没有以前熟悉的目标物理建筑的空间布局。 2。准备和熟悉ABES <ol><li>提供一个眼罩和耳机佩戴在整个培训和考核过程的参与者。确保眼罩放置在眼睛舒适和耳机的方向正确，定位在耳朵（ 即超过左耳左扬声器）。 </li><li>火车参与者如何使用分配的键的信息所表示的音频提示在ABES。使用特定的按键组合（ 图3），在用户浏览，并探讨了建筑几乎（前进，向左或向右）。每一个虚步，接近真实的物理建筑中的一个步骤。 </li><li>熟悉的游戏规则和前提。 </li><li>熟悉游戏的声音提示（ 例如声音定位的珠宝和附近的怪物的声音）。当用户浏览通过建设，收购顺序听觉和上下文的空间信息，并动态更新。空间和态势信息的基础上标志性的空间化的声音提示后采取的每一步提供。方向是基于对大是大非的指南针标题（ 例如 “北”或“东进”）和文本通过语音（TTS）是用于提供进一步的信息对于用户的当前位置，方向和标题（ 例如：“你是在楼道里的第一个楼，面向西部大开发“），以及在他们的路径（ 例如：”这是一门“）的物体和障碍物的身份。距离线索提供基于ØŇ调节声音强度。声音的空间定位进行更新以匹配用户的以自我为中心的标题。本质上，该软件被设计作为一个功能的用户的位置和自我中心标题发挥适当的音频文件，并跟踪用户的位置，因为他们通过移动环境。例如，如果一个门位于人的右侧上，在用户的右耳听到的敲击声（即软件播放的音频文件的爆震在右声道的声音）。如果现在的人打开约180度，使同门现在位于其左侧，同样的敲击声现在听到在左声道（ 即软件播放的音频文件的爆震在左声道的声音）。最后，如​​果用户所面临的门，也同样在两个耳朵听到相同的敲击声。通过跟踪用户的以自我为中心的标题，该软件可以发挥适当的空间本地化的声音识别的存在和位置的对象和跟踪这些变化作为用户通过虚拟环境中移动。参见图4。 </li></ol> 3。训练和游戏ABES（3次，每次持续30分钟共1.5小时） <ol><li>允许免费玩游戏，并注意任何困难和挑战（ 例如，使用击键，声音提示，困难的导航区域）。正强化和澄清的每一堂训练课结束时。 </li><li>记录游戏的性能（ 例如数量，时间和地点，参与者发现的一颗明珠）。 </li></ol> 4。评估实景导航任务绩效<ol><li>说明参与者的详细的测试和提供如何完成虚拟导航任务的说明。与会者将完成10个预定的导航任务，提出了按顺序使用的的ABES软件（ 即一次参与喘气成功地完成了第一个任务，计算机将自动重新定位他们的出发点以下任务）。 </li><li>通知参与者，他们将有最多6分钟完成每个导航任务。 </li><li> 10个虚拟的导航路径的选择是基于比较的困难（ 即行驶距离和圈数）10开始预定配对的停止位置（ 即房间）。具体而言，导航目标路径所需的步骤的范围介于25-35步骤（在虚拟环境中）和90度的3-4匝之间成立。 </li><li>将10导航对ABES自动化的性能介绍和数据采集。 </li><li>测试结果是使用ABES的内部软件自动记录。成果的措施包括：成功地完成导航任务和达到目标的时间。请参阅图5A。 </li><li>指令Describing的起始位置和目标中所提供由ABES软件自动在每个任务的开始。一旦受他们的第一个虚步，从起始位置和结束一次到达目标位置（除非时间需要更长的时间超过6分钟，运行取得了不完整的下一个路径），立即开始计时。捕获到的数据自动传送到一个​​文本文件，并在随后打开数据库/统计软件进行进一步的分析。 </li></ol> 5。评估身体导航任务性能<ol><li>说明的测试参与者的详细信息，并提供有关如何完成的物理导航任务的说明。与会者将完成10个预定的导航任务（加扰为了从以前的虚拟性能评估）和一个经验丰富的调查员的监督下。 </li><li>通知的参与者，他们将有一个马克西妈妈的6分钟完成每个导航任务。的物理导航任务的目的，参与者可以使用他们的白甘蔗的流动性支持。 </li><li> 10个物理的导航路径的选择是基于10的开始和停止位置（ 即室）可比的困难（ 即行驶距离和圈数）在预定的配对。 </li><li>调查准备与人工阅卷性能的导航任务列表的秒表和剪贴板。 </li><li>由调查结果的措施手工记录。成果的措施包括：成功地完成导航任务和达到目标的时间。 </li><li> “方”的参与者（ 即位置的门在他们身后的起始位置）的参与者。由研究者中所提供的每个任务的开始描述的起始位置和目标的指令。计时开始后立即受德上课他们的第一物理步骤从起始位置和结束时，参与者口头报告到达目的地（除非时间需要更长的时间超过6分钟，该运行得分作为一个完整，并提出下一路径），。捕获的数据是手工记录，然后传输到数据库/统计软件进行进一步的分析。参见图5B。 </li></ol> 6。任务绩效评估身体落<ol><li>说明的测试参与者的详细信息，并提供有关如何完成导航任务的物理落的说明。与退出的建设的目标，用最短的可能的途径和经验丰富的调查员的监督下，参加者将完成5个导航任务。 </li><li>通知参与者，他们将有最多6分钟完成每个导航任务。对于导航任务的物理落的目的，允许参与者使用白手杖的流动性支持。 </li><li> 5预定的物理起始位置用于使得3退出路径不同的长度是可能的。 </li><li>调查准备与人工阅卷性能的导航任务列表的秒表和剪贴板。 </li><li>由调查结果的措施手工记录。成果的措施包括：成功地完成导航任务和达到目标的时间。此外，路径取得了最高点的最短路径的最短路径（ 即 3个，2代表第二个，最长的1和0为不能够完成的任务）。参见图5C。 </li><li> “广场”的参与者在第一的位置。由研究者在开始每个任务中所提供的描述的开始位置的指令。一旦受他们的第一个步骤，从起始位置和结束，立即开始计时当参与者口头报告到达出口门的建筑（，除非时间需要更长的时间超过6分钟，运行取得了不完整，下一个起始位置）。捕获的数据是手工记录，然后传输到数据库/统计软件进行进一步的分析。 </li></ol>

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	<li>Loomis, J. M., Klatzky, R. L., Golledge, R. G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Navigating+without+vision:+basic+and+applied+research.">Navigating without vision: basic and applied research.</a> Optom. Vis. Sci. 78, 282-289 (2001).</li><li>Siegel, A. W., White, S. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+development+of+spatial+representations+of+large-scale+environments.">The development of spatial representations of large-scale environments.</a> Adv. Child Dev. Behav. 10, 9-55 (1975).</li><li>Strelow, E. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=What+is+needed+for+a+theory+of+mobility:+direct+perception+and+cognitive+maps--lessons+from+the+blind.">What is needed for a theory of mobility: direct perception and cognitive maps--lessons from the blind.</a> Psychol. Rev. 92, 226-248 (1985).</li><li>Giudice, N. A., Bakdash, J. Z., Legge, G. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Wayfinding+with+words:+spatial+learning+and+navigation+using+dynamically+updated+verbal+descriptions.">Wayfinding with words: spatial learning and navigation using dynamically updated verbal descriptions.</a> Psychol. Res. 71, 347-358 (2007).</li><li>Ashmead, D. H., Hill, E. W., Talor, C. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Obstacle+perception+by+congenitally+blind+children.">Obstacle perception by congenitally blind children.</a> Percept. Psychophys. 46, 425-433 (1989).</li><li>Dede, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Immersive+interfaces+for+engagement+and+learning.">Immersive interfaces for engagement and learning.</a> Science. 323, 66-69 (2009).</li><li>Bavelier, D., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Brains+on+video+games.">Brains on video games.</a> Nat. Rev. Neurosci. 12, 763-768 (2011).</li><li>Bavelier, D., Green, C. S., Dye, M. W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Children,+wired:+for+better+and+for+worse.">Children, wired: for better and for worse.</a> Neuron. 67, 692-701 (2010).</li><li>Lange, B., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Designing+informed+game-based+rehabilitation+tasks+leveraging+advances+in+virtual+reality.">Designing informed game-based rehabilitation tasks leveraging advances in virtual reality.</a> Disabil. Rehabil. , (2012).</li><li>Merabet, L., S&#225;nchez, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Audio-based+Navigation+Using+Virtual+Environments:+Combining+Technology+and+Neuroscience.">Audio-based Navigation Using Virtual Environments: Combining Technology and Neuroscience.</a> AER Journal: Research and Practice in Visual Impairment and Blindness. 2, 128-137 (2009).</li><li>Kalia, A. A., Legge, G. E., Roy, R., Ogale, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Assessment+of+Indoor+Route-finding+Technology+for+People+with+Visual+Impairment.">Assessment of Indoor Route-finding Technology for People with Visual Impairment.</a> J. Vis. Impair. Blind. 104, 135-147 (2010).</li><li>Lahav, O., Schloerb, D. W., Srinivasan, M. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Newly+blind+persons+using+virtual+environment+system+in+a+traditional+orientation+and+mobility+rehabilitation+program:+a+case+study.">Newly blind persons using virtual environment system in a traditional orientation and mobility rehabilitation program: a case study.</a> Disabil. Rehabil. Assist Technol. , (2011).</li></ol>

作者宣称没有利益冲突。

我们描述一个互动的虚拟环境仿真，旨在改善空间意识和导航技术的盲目。我们表明，与ABES提供准确线索，描述对象之间的空间关系和整体布局的目标环境。盲人用户可以生成精确的空间认知地图，在此听觉信息和身临其境的虚拟环境的互动。此外，与ABES范围内的游戏比喻表明，空间认知结构，可以学到隐含因果互动的软件，而不是简单地通过。在这个初始阶段的研究表明，互动和身临其境的?...

在一个陌生的环境中找到自己的方式表现为盲人作为一个重大的挑战。导航成功，需要了解一个人的自我环境中的1,2和对象之间的空间关系存在。周围空间的心理表征，描述了被称为“空间认知地图3。盲人可以通过收集相关的空间信息，其周围的环境可以生成一个精确的空间认知地图的目的，现实世界中的导航任务4,5的其他感觉通道（如听觉）。 动作视频游戏作为一种手段，学习和掌握技能6-9虚拟环境和教育的潜力方面出现相当大的兴趣。事实上，许多策略和方法已经开发了用于此目的的盲人（4,10-12）。我们已经开发了奥迪基于邻环境模拟器（ABES），以用户为中心的基于音频的虚拟环境，允许现有的物理建筑为模拟导航和探索。利用原有的建筑平面布置图，一个虚拟的渲染一个现代化的两层楼的建筑（位于卡罗尔中心的盲人，牛顿，MA）生成的的ABES软件（ 图1A和B）。 ABES结合了动作游戏的比喻，促进全面探索的建筑空间设计的前提。使用简单的击键和空间化的声音提示，用户浏览和探索整个建筑隐藏在各个房间收集到最大数量的珠宝。用户必须避免巡回怪物，可以把他们带走，并隐藏在其他地方建设（ 图1C）。 我们表明，与ABES使盲人用户产生一个精确的空间认知地图，基于对听觉信息的目标楼宇cquired范围内的一款动作游戏的比喻。一系列培训后的行为表现的测试，目的是评估转移获得的空间信息从虚拟环境到一个真实的世界，大型室内导航任务（参见图2为总体研究设计）证实了这一点。我们的研究结果表明，盲人用户能够成功地驾驭整个建筑，他们以前不熟悉，尽管事实上，在任何时候他们的整体研究的目的，也没有通知他们的指示回忆的空间布局，建设边玩游戏。

<table border="1"><tbody><tr><td> 设备名称 </td><th >评论</td></tr><tr><td>笔记本电脑</td><td >专为笔记本电脑使用培训参与者和收集数据</td></tr><tr><td>立体声耳机（全封闭的耳罩设计） </td><td >所有参加者在训练中所穿</td></tr><tr><td>盲目的</td><td >所有参加者在训练和测试所穿</td></tr></tbody></table>

development of an audio-based virtual gaming environment to assist with navigation skills in the blind

基于音频的环境模拟器（ABES），是真正的全球导航能力，旨在提高在盲目的虚拟环境软件。用户只使用音频线索，并设置范围内的视频游戏比喻，收集相关的空间信息有关建筑物的布局。这允许用户制定了大规模的三维空间中，可以被操纵一个真正的室内导航任务为施行准确的空间认知的地图。游戏结束后，与会者评估他们的代表在游戏中的目标物理建筑内的导航能力。初步结果表明，早期盲人用户能够获得的空间布局，以前不熟悉的建筑被他们的表演了一系列的导航任务索引的相关信息。这些任务包括寻找路径，通过虚拟和物理的建筑，以及一系列任务落。我们发现，身临其境的高度交互性的的ABES软件的出现，极大地从事盲人用户，积极探索虚拟环境。这种方法的应用可以扩展到人口较多的视障人士。

从早期的盲目参与者（年龄介乎19至22岁）的结果显示参与者的特点（ 见表1）。总之，所有与会者表现出高层次的成功在所有这三个导航任务ABES软件与游戏。证实了这一点的表现的分数（组均值和个人）在所有三个行为的任务（ 见图6）。正确的比例表现为虚拟（平均90％），其次是物理的（平均88.7％）导航任务说明了一个高层次的成功和相当的性能，这两个任务（ <stro...

Watch this Scientific Journal Video about Development of an Audio-based Virtual Gaming Environment to Assist with Navigation Skills in the Blind at JoVE.com

Development of an Audio-based Virtual Gaming Environment to Assist with Navigation Skills in the Blind

基于音频的环境模拟器（ABES），是真正的全球导航能力，旨在提高在盲目的虚拟环境软件。

基于音频的虚拟游戏环境的发展，以帮助盲人的导航技巧

Audio-based Environment Simulator (AbES) is virtual environment software designed to improve real world navigation skills in the blind. Using only audio ...

development-an-audio-based-virtual-gaming-environment-to-assist-with

Research

JoVE Journal

Medicine

14.2K 次观看.  Massachusetts Eye and Ear Infirmary, Harvard Medical School. 基于音频的环境模拟器（ABES），是真正的全球导航能力，旨在提高在盲目的虚拟环境软件。

视频: Development of an Audio-based Virtual Gaming Environment to Assist with Navigation Skills in the Blind

Using Quantitative Real-time PCR to Determine Donor Cell Engraftment in a Competitive Murine Bone Marrow Transplantation Model

Murine bone marrow transplantation models provide an important tool in measuring hematopoietic stem cell (HSC) functions and determining genes/molecules that regulate HSCs. In these transplant model systems, the function of HSCs is determined by the ability of these cells to engraft and reconstitute lethally irradiated recipient mice. Commonly, the donor cell contribution/engraftment is measured by antibodies to donor- specific cell surface proteins using flow cytometry. However, this method heavily depends on the specificity and the ability of the cell surface marker to differentiate donor-derived cells from recipient-originated cells, which may not be available for all mouse strains. Considering the various backgrounds of genetically modified mouse strains in the market, this cell surface/ flow cytometry-based method has significant limitations especially in mouse strains that lack well-defined surface markers to separate donor cells from congenic recipient cells. Here, we reported a PCR-based technique to determine donor cell engraftment/contribution in transplant recipient mice. We transplanted male donor bone marrow HSCs to lethally irradiated congenic female mice. Peripheral blood samples were collected at different time points post transplantation. Bone marrow samples were obtained at the end of the experiments. Genomic DNA was isolated and the Y chromosome specific gene, Zfy1, was amplified using quantitative Real time PCR. The engraftment of male donor-derived cells in the female recipient mice was calculated against standard curve with known percentage of male vs. female DNAs. Bcl2 was used as a reference gene to normalize the total DNA amount. Our data suggested that this approach reliably determines donor cell engraftment and provides a useful, yet simple method in measuring hematopoietic cell reconstitution in murine bone marrow transplantation models. Our method can be routinely performed in most laboratories because no costly equipment such as flow cytometry is required.

Determining donor cell engraftment presents a challenge in mouse bone marrow transplant models that lack well-defined phenotypical markers. We described a methodology to quantify male donor cell engraftment in female transplant recipient mice. This method can be used in all mouse strains for the study of HSC functions.

采用实时定量PCR检测供体细胞植入一个具有竞争力的小鼠骨髓移植模型

Murine bone marrow transplantation models provide an important tool in measuring hematopoietic stem cell (HSC) functions and determining genes/molecules ...

科研

医学

Development of an Algorithm to Perform a Comprehensive Study of Autonomic Dysreflexia in Animals with High Spinal Cord Injury Using a Telemetry Device

Spinal cord injury (SCI) is a debilitating neurological condition characterized by somatic and autonomic dysfunctions. In particular, SCI above the mid-thoracic level can lead to a potentially life-threatening hypertensive condition called autonomic dysreflexia (AD) that is often triggered by noxious or non-noxious somatic or visceral stimuli below the level of injury. One of the most common triggers of AD is the distension of pelvic viscera, such as during bladder and bowel distension or evacuation. This protocol presents a novel pattern recognition algorithm developed for a JAVA platform software to study the fluctuations of cardiovascular parameters as well as the number, severity and duration of spontaneously occurring AD events. The software is able to apply a pattern recognition algorithm on hemodynamic data such as systolic blood pressure (SBP) and heart rate (HR) extracted from telemetry recordings of conscious and unrestrained animals before and after thoracic (T3) complete transection. With this software, hemodynamic parameters and episodes of AD are able to be detected and analyzed with minimal experimenter bias.

The catheter of a telemetry device is implanted into the abdominal aorta in order to continuously collect beat-by-beat hemodynamic data from animals pre and post-high thoracic spinal cord transection. A novel JAVA software was employed to analyze hemodynamic parameters as well as frequency and intensity of spontaneous episodes of autonomic dysreflexia.

一个算法的开发与高位脊髓损伤使用遥测装置进行自主神经异常反射的动物的综合研究

Spinal cord injury (SCI) is a debilitating neurological condition characterized by somatic and autonomic dysfunctions. In particular, SCI above the ...

Determination of the Relative Potency of an Anti-TNF Monoclonal Antibody (mAb) by Neutralizing TNF Using an In Vitro Bioanalytical Method

This protocol shows the measurement of the apoptotic activity neutralization of TNF&#945; in a mouse fibroblast cell model (WEHI 164) using an anti-TNF&#945; mAb. In addition, this protocol can be used to evaluate other anti-TNF&#945; molecules, such as fusion proteins. The cellular model employed here is sensitive to TNF&#945;-mediated apoptosis when an additional stress factor is induced in cell culture conditions (e.g., serum deprivation). This procedure exemplifies how to execute this analytical assay, highlighting the key operations relating to the sample preparation, cell dilution, apoptosis induction, and spectrophotometric measurements that are critical to ensure successful results. This protocol reveals the best-performance conditions relating to apoptosis induction and efficient signal recording, leading to low uncertainty values.

Determination of the Relative Potency of an Anti-TNF Monoclonal Antibody mAb by Neutralizing TNF Using an In Vitro Bioanalytical Method

A protocol for the determination of the relative anti-apoptotic activity of an anti-TNF&#945; mAb using a neutralization mechanism with WEHI 164 cells is presented here. This protocol is useful for comparing the neutralization strength of different molecules with the same biological functionality.

使用体外生物法测定抗 tnf 单克隆抗体 (抗体) 的相对效力

This protocol shows the measurement of the apoptotic activity neutralization of TNF&#945; in a mouse fibroblast cell model (WEHI 164) using an ...

Re-Arterialized Rat Partial Liver Transplantation with an in vivo Vessel-Oriented 70% Hepatectomy

Split liver transplantation and living liver donor liver transplantation were developed in the clinic to utilize liver organs in a more efficient manner. To better understand the mechanism behind these surgical procedures, a rat partial liver transplantation (PLTx) model was established for relevant surgical studies. Because of the complexity of the rat PLTx model, a protocol with detailed descriptions is required. An article published previously reported a protocol in which ex vivo hepatectomy was used to achieve 50% rat PLTx. In contrast to this protocol, we introduced a re-arterialized PLTx with an in vivo 70% hepatectomy. An updated vessel-oriented hepatectomy was incorporated into the rat PLTx to refine the microsurgical procedure. The portal veins and hepatic arteries of the left lateral lobe and the median lobe were individually dissected and ligated before removal of the liver parenchyma, thereby decreasing the probability of bleeding in the remnant liver stump. Furthermore, an end-to-side vessel anastomosis between the common hepatic artery and the enlarged proper hepatic artery was introduced to re-arterialize the hepatic artery. By using this end-to-side vessel anastomosis technique, the diameter of the anastomosis was enlarged, thereby decreasing the difficulty of hand suture and maintaining a high rate of anastomotic patency. Moreover, the cuff anastomosis of the infrahepatic vena cava was slightly modified. A section of circumferential liver parenchyma around the vena cava of a recipient was preserved during cuff anastomosis to maintain the three-dimensional shape of the vascular lumen. This section of liver parenchyma was removed after completing the anastomosis. With this modification, the step involving placement of stay sutures was omitted, thereby further shortening the cuff anastomosis time. By using this protocol of rat PLTx, a low liver enzyme level, an intact liver lobular architecture and a high survival rate were achieved after microsurgery.

Re-Arterialized Rat Partial Liver Transplantation with an in vivo Vessel-Oriented 70% Hepatectomy

Here, a protocol involving re-arterialized rat partial liver transplantation is presented. Specifically, 70% liver was resected in vivo by using an updated technique of vessel-oriented hepatectomy. The hepatic artery was reconstructed in an end-to-side manner. The cuff technique was modified to shorten the anastomosis time of the infrahepatic vena cava.

静脉大鼠部分肝移植的体内血管定向70% 肝切除术

Split liver transplantation and living liver donor liver transplantation were developed in the clinic to utilize liver organs in a more efficient manner. ...

Assessment of the Efficacy of An Osteopathic Treatment in Infants with Biomechanical Impairments to Suckling

Breastfeeding can be challenging for mother-infant dyads experiencing biomechanical suckling difficulties. Although lactation consultants (LCs) all over the world have increased their skills in this field and can provide support to help position the infant at the breast, the impact of their intervention might be limited in the presence of stiff structures in the infants. Here we present a protocol for a randomized controlled trial to assess the efficacy of osteopathic treatment, coupled with lactation consultation, for infants&#39; biomechanical suckling difficulties. It proposes a set-up and a sequence of actions to ensure an optimal context for treatment, as well as a blinding of parents and LCs to the intervention. Data such as the infant&#39;s latch ability measured with the LATCH Assessment Tool, the mother&#39;s nipple pain with a visual analog scale (VAS), and the mother&#39;s perceptions are collected by LCs four times over a 10-day period. Osteopathic lesions are documented by the osteopath, using a standardized assessment grid. Structures of interest are coherent with the anatomical zones involved in latching onto the breast. This protocol also proposes a strategy to document systematically an osteopathic profile of infants with biomechanical suckling difficulties in their first weeks of life. The implementation of this protocol confirms its feasibility for osteopathic assessment and treatment and paves the way for future trials to further explore the efficacy of osteopathic techniques for infants with biomechanical suckling difficulties.

Osteopathy is an emerging field of clinical research. Here we present a protocol to assess the efficacy of an osteopathic intervention coupled with lactation consultation, in infants with biomechanical issues impeding breastfeeding.

骨科治疗婴儿生物力学损伤对吸血效果的评价

Breastfeeding can be challenging for mother-infant dyads experiencing biomechanical suckling difficulties. Although lactation consultants (LCs) all over ...

A Computerized Functional Skills Assessment and Training Program Targeting Technology Based Everyday Functional Skills

Today, many functional skills are technology-based, so development of a technology-based training program has broad importance. Here we present a computerized functional skills training program that was paired in half of the participants with a commercially available cognitive training (CCT) program.
Non-impaired older individuals (NC) aged 60+ (n=45) and similarly aged individuals with mild cognitive impairment (MCI; n=50) were randomized to receive 12 weeks of twice-weekly computerized functional skills training (CFST) or 12 weeks of twice-weekly sessions split between CCT and CFST. Skills trained were use of an ATM; internet banking; ticket kiosk; telephone and internet prescription refill; medication management; and internet shopping. As with previous functional capacity assessments, we focus on completion time for each simulation.
51 participants completed the training program, either by mastering all 6 tasks (34) or completing 12 weeks of training. 44 more participants completed 4 or more training sessions so they were also analyzed for improvement up to their last training session. Completion time for all 6 tests significantly improved from the baseline assessment to the final training session in both groups of participants (all p&#60;0.001 with an average improvement in task completion time of 45%). Further, there was no differential improvement in MCI and NC in the 6 tests from baseline to end of training (all t&#60;1.66, all p&#62;0.12). Finally, combined CCT plus CFST did not differ from CSFT alone on any of the percent-change score measures (all t&#60;1.64, all p&#62;0.11).
Both NC and MCI groups evidenced substantial improvements in performance. CCT supplementation led to similar functional gains with half as many training sessions. The NC participants proceeded through the training fairly rapidly even without CCT supplementation; MCI participants required more training but learned equivalently. These findings suggest that even in cases with memory impairments, functional skills can be efficiently learned with training.

This training protocol uses computerized training to teach technology-related everyday functional skills. These skills include financial skills, travel and transit, as well as medication management.

以基于技术的日常功能技能为目标的计算机化功能技能评估和培训计划

Today, many functional skills are technology-based, so development of a technology-based training program has broad importance. Here we present a ...

Blind Endotracheal Intubation in Neonatal Rabbits

The newborn rabbit is a useful animal model for various pathologies and procedures. Airway management of the rabbit is complex due to its anatomical characteristics, which is further complicated in the case of the newborn. Of the different methods of advanced airway management, endotracheal intubation is less aggressive than tracheostomy, and is more feasible than supraglottic management given the lack of supraglottic devices of such a small size. As direct glottis visualization is very difficult in animals this size, this blind intubation model is presented as an effective alternative, especially for experiments requiring prolonged anesthesia. Using this method, we performed blind intubations with a 90% success rate.

We describe a technique of endotracheal intubation in newborn rabbits after esophageal catheterization with a gastric tube.

新生儿兔子的盲内窥管插管

The newborn rabbit is a useful animal model for various pathologies and procedures. Airway management of the rabbit is complex due to its anatomical ...

Real-Time Dynamic Navigation System for the Precise Quad-Zygomatic Implant Placement in a Patient with a Severely Atrophic Maxilla

Zygomatic implants (ZIs) are an ideal way to address cases of a severely atrophic edentulous maxilla and maxilla defects because they replace extensive bone augmentation and shorten the treatment cycle. However, there are risks associated with the placement of ZIs, such as penetration of the orbital cavity or infra-temporal fossa. Furthermore, the placement of multiple ZIs makes this surgery risky and more difficult to perform. Potential intraoperative complications are extremely dangerous and may cause irreparable losses. Here, we describe a practical, feasible, and reproducible protocol for a real-time surgical navigation system for precisely placing quad-zygomatic implants in the severely atrophic maxilla of patients with residual bone that does not meet the requirements of conventional implants. Hundreds of patients have received ZIs at our department based on this protocol. The clinical outcomes have been satisfactory, the intraoperative and postoperative complications have been low, and the accuracy indicated by infusion of the designed image and postoperative three-dimensional image has been high. This method should be utilized during the entire surgical procedure to ensure ZI placement safety.

Here, we present a protocol to achieve precise quad-zygomatic implant placement in patients with severely atrophic maxilla using a real-time dynamic navigation system.

实时动态导航系统，用于在严重萎缩性上颌骨患者中精确放置四颧植入物

Zygomatic implants (ZIs) are an ideal way to address cases of a severely atrophic edentulous maxilla and maxilla defects because they replace extensive ...

Dynamic Navigation in Endodontics: Guided Access Cavity Preparation by Means of a Miniaturized Navigation System

In the case of teeth with pulp canal calcification (PCC) and apical pathology or pulpitis, root canal treatment can be very challenging. PCC are common sequelae of dental trauma but can also occur with stimuli such as caries, bruxism, or after placing a restoration. In order to access the root canal as minimally invasive as possible in case of a necessary root canal treatment, dynamic navigation has recently been introduced in endodontics in addition to static navigation. The use of a dynamic navigation system (DNS) requires pre-operative cone-beam computed tomography (CBCT) imaging and a digital surface scan. If necessary, reference markers must be placed on the teeth before the CBCT scan; with some systems, these can also be planned and created digitally afterward. By means of a stereo camera connected to the planning software, the drill can now be coordinated with the help of reference markers and virtual planning. As a result, the position of the drill can be displayed on the monitor in real-time during preparation in different planes. In addition, the spatial displacement, the angular deviation, and the depth position are also displayed separately. The few commercially available DNS mostly consist of relatively large camera-marker-systems. Here, the DNS contains miniaturized components: a low-weight camera (97 g) mounted on the micromotor of the electric handpiece utilizing a manufacturer-specific connecting mechanism and a small marker (10 mm x 15 mm), which can be easily attached to an individually manufactured intraoral tray. For research purposes, a post-operative CBCT scan can be matched with the pre-operative one, and the volume of tooth structure removed can be calculated by the software. This work aims to present the technique of guided access cavity preparation by means of a miniaturized navigation system from imaging to clinical implementation.

Dynamic navigation systems (DNS) provide real-time visualization and guidance to the operator during endodontic access cavities preparation. The planning of the procedure requires three-dimensional imaging utilizing cone beam computed tomography and surface scans. After the export of the planning data to the DNS, access cavities can be prepared with minimal invasion.

牙髓病学中的动态导航：通过小型化导航系统进行引导通路腔准备

In the case of teeth with pulp canal calcification (PCC) and apical pathology or pulpitis, root canal treatment can be very challenging. PCC are common ...

Vessel-Sparing Microsurgical Longitudinal Intussusception Vasoepididymostomy to Treat Epididymal Obstructive Azoospermia

The epididymis is a common site of obstruction in obstructive azoospermia (OA). Vasoepididymostomy has become an important method for the treatment of epididymal OA since 2000. There are two challenges in classic microscopic vasoepididymostomy. First, anastomosis of the vas deferens and epididymis is performed with double-needle sutures. However, there is a lack of good-quality and cost-effective double-needle sutures in China, which leads to increased difficulty and poor success rates of anastomosis. Second, the separation of the vas deferens does not retain vasculature, although the vas deferens vasculature plays an important role in the blood supply to the vas deferens, epididymis, and testis. This affects the blood supply to the anastomotic area and epididymis.
Therefore, this team has made innovative improvements to address these problems. Good-quality, cost-effective, single-needle sutures, which are easy to purchase in China and other countries, were used in microsurgical longitudinal intussusception vasoepididymostomy. This can optimize the operation procedure and shorten the operation time while ensuring the success rate of the anastomosis. The surgical method of preserving the vas deferens vessels was innovatively proposed because the etiology of epididymal OA is mostly inflammatory in China. The protection of the blood supply to the vas deferens and epididymis is maximized using microsurgical forceps to separate and protect the vasculature. Patency reached 81.7% in the postoperative follow-up, indicating a better surgical treatment effect.

The present protocol describes a vessel-sparing, longitudinal intussusception vasoepididymostomy using readily available single-needle sutures in China, a safe and effective procedure, which may improve patients' patency and natural pregnancy rates.

血管保留性显微外科纵向套叠血管表皮造口术治疗附睾梗阻性无精子症

The epididymis is a common site of obstruction in obstructive azoospermia (OA). Vasoepididymostomy has become an important method for the treatment of ...