No description available.

Objectives: To study the treatment practice of chronic tennis elbow (TE) among general practitioners (GPs) and physiotherapists (PTs), the effects of a simple, graded home exercise regime versus expectation, the effects of eccentric versus concentric exercise, and the involvement of the substance P – NK1 receptor system in the peripheral, painful tissue of chronic TE patients by positron emission tomography (PET). Materials and methods: A postal survey regarding therapeutic methods used in patients with chronic TE was sent to 129 GPs and 77 PTs, 81 subjects with chronic TE were randomly and blindly assigned to either an exercise group or a wait list group, 120 subjects were randomly assigned to either eccentric or concentric exercise and ten subjects were examined by PET and the NK1 specific radioligand [11C]GR205171. Results: High proportions of GPs and PTs used ergonomic counselling and stretching in the treatment of chronic TE. The majority of GPs prescribed passive anti-inflammatory measures such as sick leave and anti-inflammatory medication. Many PTs prescribed dynamic, particularly eccentric, exercise. Graded dynamic exercise according to a simple low-cost protocol, has better effect on pain than a wait-and-see attitude. Adjusted for outcome affecting variables, eccentric graded exercise has quicker effect than concentric graded exercise. During PET scan with the NK1 specific radioligand [11C]GR205171, voxel volume and signal intensity of this volume was significantly higher in the affected than the unaffected arm in subjects with unilateral chronic TE. Conclusions: GPs and PTs used many treatments to a similar extent but differed regarding the use of exercise. Chronic TE responds favourably to graded dynamic exercise aimed specifically at the painful tissue. The exercise should stress the eccentric work phase. The substance P – NK1 receptor system seems to play a part in the peripheral, painful tissue of a chronic, soft tissue pain condition such as chronic TE. / Epi-X

Parallèlement aux adaptations cardiovasculaires et neuromusculaires, les exercices mono-articulaires ou locomoteurs peuvent induire des changements neuroplastiques de muscles impliqués ou non dans l’exercice. Si l’effet de paramètres de l’exercice, comme l’intensité ou la durée, sur les changements neuroplastiques ont déjà été étudiés, l’effet du mode de contraction musculaire reste, quant à lui, moins connu. L’objectif de cette thèse a été d’évaluer les effets du mode de contraction musculaire sur les changements neuroplastiques consécutifs à un exercice locomoteur ou mono-articulaire. La première étude a montré que l’augmentation de l’excitabilité corticospinale d’un muscle non-impliqué dans l’exercice (muscle de la main), observée suite à un exercice de marche/ course, n’était pas modulée par le mode de contraction des muscles extenseurs du genou. En revanche, une modulation spécifique des réseaux intracorticaux par le mode de contraction impliqué lors d’un exercice a été mise en évidence par l’application d’un protocole de stimulation associative jumelée. Des observations similaires ont été faites dans une seconde étude investiguant les changements corticospinaux observés au niveau des muscles extenseurs du genou impliqués dans des exercices mono-articulaires fatigants, effectués dans un mode de contraction concentrique ou excentrique. Une troisième étude a montré que pour un exercice de marche/ course réalisé à même fréquence cardiaque en montée, à plat ou en descente, la modalité en descente induisait une fatigue musculaire des extenseurs du genou plus importante, avec des altérations contractiles plus marquée. La quatrième étude a montré que seule la modalité en descente induisait une augmentation de l’excitabilité corticospinale, et une réduction de l’inhibition corticale des muscles extenseurs du genou. Les travaux de cette thèse proposent que le mode de contraction musculaire lors d’un exercice n’est, en lui-même, pas un facteur prépondérant des changements neuroplastiques observés pour des muscles impliqués dans l’exercice. Ces changements neuroplastiques seraient au contraire dépendant de la magnitude de la fatigue neuromusculaire induite, elle-même dépendante du mode de contraction musculaire. / Along with cardiovascular and neuromuscular changes, mono-articular and locomotor exercises may induced neuroplastic changes from muscles involved, or non-involved, in the exercise. If the effect of exercise intensity or duration on neuroplastic changes has been previously investigated, the effect of the mode of muscle contraction remains unclear. The aim of this thesis was to investigate the effects of the mode of muscle contraction on neuroplastic changes induced a locomotor or a single-joint exercise. The first study showed that the increase in the corticospinal excitability of a non-exercised hand muscle, observed after a walking/ running exercise, was not modulated by the knee extensors mode of muscle contraction. However, a specific modulation of the intracortical networks by the mode of muscle contraction was evidenced using a paired-associative stimulation protocol. Similar findings were made in a second study that investigated corticospinal changes in the knee extensors following a fatiguing single-joint exercise, performed in either a concentric or an eccentric mode of muscle contraction. A third study showed that for a walking/ running exercise performed at the same heart rate in either a inline, a level or a decline condition, the latter condition induced a greater magnitude of neuromuscular fatigue of the knee extensors, with greater contractile impairments. The fourth study reported that only a decline exercise induced an increase in the corticospinal excitability, and a reduction of the cortical inhibition of the knee extensors. Altogether, findings from this thesis suggest that the mode of muscle contraction during an exercise is not, per se, a main factor responsible for neuroplastic changes observed in exercised muscles. Rather, these changes may depend upon the magnitude of neuromuscular fatigue induced, which could depend upon the mode of muscle contraction involved during exercise.

No description available.

The recognition of fault-perturbed stress fields is an important tool in areas of mineral or hydrocarbon exploration. The Bowie underground coal mines of western Colorado expose a reverse-reactivated growth fault that perturbed the stress field during cleat (fracture) formation, rotating cleat orientations up to 500 m on both sides of the fault. Two unusual fracture types are found only in coal adjacent to the fault: (1) concentric cleats, highly curved fractures that form blocks resembling balls or eggs and (2) horsetail cleats, striated surfaces that superficially resemble shattercones and result from shear failure in coal. Numerical models created with the boundary element program Poly3D were used to estimate the magnitudes and orientations of the paleostress axes during cleat formation, taking into account the depth of burial, 3-D fault orientation, elastic rock parameters, and far-field stress states. When the elastic rock parameters and modeled orientations of the stress axes are held constant, the relative stress ratio, R = (σ_1 — σ_2)/(σ_2 — σ_3), uniquely determines the orientations of fractures forming in the fault-perturbed stress field. Comparison of the models with systematic observations on both sides of the fault allows the selection of a best-fit model. If the depth of overburden during fracture formation is known, this technique can be used to estimate the magnitude of σ_1 in fault-perturbed areas. The rotated face cleats and unusual, fault-related cleat types provide unequivocal evidence of a fault when (1) the fault predates cleat formation and (2) the far-field horizontal stress during cleat formation is oblique to fault strike. In addition, the varying spatial association of these fault-perturbed cleat styles with the fault may provide a qualitative estimate of fault location while mining. Pre-existing faults also strongly control reactivation-related folding, which at formed several low-amplitude folds, including a footwall fold. Igneous sills in three Bowie coal seams show strong preference for fault zones. The recognition of similar fracture trends in other mining or exploration areas is a valuable tool that may significantly reduce economic or human cost by helping to mitigate fault-related hazards and highlighting potentially productive zones in faulted reservoirs.

No description available.

Biochemical markers of bone turnover allow inference of the events occurring at the bone tissue level and may detect changes in bone cell activity earlier than densitometric technologies. Serum concentrations of receptor activator for nuclear factor kappa-beta ligand (RANKL), osteoprotegerin (OPG), osteocalcin, and N-telopeptide (NTx) were measured in women aged 20 + 1.5 years (mean + SD) who underwent 32 weeks of unilateral isokinetic concentric or eccentric muscular strength training. Changes in serum biomarkers were compared with changes in arm and leg flexor and extensor muscle strength. Dual X-ray absorptiometry (DXA) measures of bone mineral density (BMD) and bone mineral content (BMC) of the total forearm, total tibia, and total body also were assessed. The mean serum OPG concentration increased from 4.6 + 1.9 pmol/L to 5.2 + 2.1 pmol/L (â 14.9 %, mean + SD; p = 0.05, n = 20) following long-term isokinetic exercise training that also increased elbow extensor and knee flexor muscular strength (p < 0.05) and total forearm BMD (p = 0.04). The ratio of OPG/RANKL also increased over the course of the study (p = 0.045). Serum concentrations of other measured bone biomarkers did not change during training. Serum concentrations of OPG, a suppressor of osteoclastogenesis, increased with high-load muscular strength training that led to local increases in muscle strength and BMD. These adaptations may represent an exercise-mediated suppression of osteoclast differentiation and activity. The central role of the RANKL-OPG cytokine system in the regulation of bone cell biology is well established. Further research is needed to confirm the efficacy of using serum OPG and RANKL as biomarkers of bone cell metabolism in healthy populations undergoing long-term exercise interventions. / Master of Science

Les robots à tubes concentriques deviennent de plus en plus populaires dans la communauté de la robotique médicale. Dans cette thèse, un état de l’art général des travaux existants et qui couvre les thématiques de recherche en robots à tubes concentriques (RTC) est présenté dans un premier temps. Les modélisations géométrique (directe et inverse) et cinématique des RTC sont détaillées car elles servent de base pour les contributions de cette thèse. La première contribution consiste en une étude de concept d’utilisation des RTCs pour la résection des tumeurs profondes situées au niveau du lobe frontal du cérveau. ‘Grid searching’a été utilisée comme méthode d’optimisation pour la conception des tubes des RTCs. Cette méthode permet d’éviter le problème crucial de présélection des coefficients de pondération, cette pondération étant nécessaire dans toutes les méthodes de scalarisation existantes dans la litérature. La méthode de ‘grid searching’ utilisée dans ce travail permet la sélection des paramères optimaux avec l’aide d’une illustration graphique de la distribution des résultats de calcul concernant les critères de séléction. La stabilité élastique due aux interactions destubes en flexion et en torsion est incluse dans les critères de séléction et est évaluée avec une nouvelle approche introduite dans ce travail. La deuxième contribution de cette thèse repose sur la synthèse d’une loi de commande qui permet de faire face aux incertitudes cinématiques dans le contrôle de mouvement des RTCs. L’étude réalisée a montré qu’un contrôle au niveau des couples moteurs avec un retour dans l’espace opérationnel et une matrice Jacobienne approchée, ce contrôle assure une robustesse en présence des incertitudes cinématiques au niveau de la matrice Jacobienne et permet d’obtenir des bonnes performances de contrôle en terme d’erreur de poursuite. / Concentric Tube Robots (CTR) are becoming more and more popular in medical robotics community. In this thesis, a general literature survey on existing works covering the research topics of CTR is first presented. The kinematics of CTR is more specifically detailed since it is the basics of the main contributions of this thesis. The first contribution is a concept study of exploiting CTR for resection of deep brain tumors located at the frontal lobe. Grid searching has been used as the optimization method for the CTR tubes design. This method allows to avoid the crucial problem of weights preselection which is required in all scalarizationmethods existing in literature. Instead, the grid searching method used in this work allows to choose the optimal parameters with the help of graphical illustration of calculation results distribution with respect to the selection criteria. The elastic stability dues to the bending and torsion interaction between tubes is considered and evaluated with a new approach introduced in this work. The second contribution then is to deal with the kinematic uncertainties in motion control of CTR. The proposed control method designed at the actuator level shows that the control design of actuator input with task-space feedback and approximate Jacobian matrix provides robustness in handling inaccuracy in kinematic model and maintains good control performance at the same time.

The period of early life is important for the development of individual brain function and behavior. Human studies have shown altered vulnerability to develop psychopathology and/or excessive drug intake, possibly leading to dependence, as a consequence of early life experiences. In the present thesis, maternal separation (MS), an experimental model for studies of early environmental influences, was used to investigate long-term effects on neurochemistry, voluntary ethanol intake and exploration and risk assessment behavior in rats. Rat pups were assigned to one of three different rearing conditions: daily 15 min (MS15) or 360 min (MS360) of MS and normal animal facility rearing (AFR) during the first three weeks of life. Measurements of adult endogenous opioid peptide levels, opioid- and dopamine receptor density revealed minor MS-induced effects on the opioid system whereas interesting alterations were found in dopamine receptor density. Long-term effects on voluntary ethanol intake showed distinct MS-induced alterations in male Wistar and ethanol-preferring AA (Alko, Alcohol) rats. Female Wistar rats were unaffected, indicating sex differences in the effects of MS on ethanol intake. Male MS15 rats generally had a slower acquisition phase and a low subsequent ethanol intake whereas male MS360 rats had a high ethanol intake. MS15 is therefore suggested to protect against a high voluntary ethanol intake in male rats whereas MS360 may serve as a risk factor. The recently established concentric square field test indicated alterations in risk assessment as well as an increased exploratory drive and somewhat higher risk-taking behavior in adult MS360 rats, while minor effects were seen in MS15 rats. Altogether, these results demonstrate that environmental influences during the period of early life can have long-term effects on neurochemistry and behavior. Of special interest is the finding that MS altered the inherited high ethanol intake in adult ethanol-preferring AA rats.

The quantitative analysis of decomposed electromyographic (EMG) signals reveals information for diagnosing and characterizing neuromuscular disorders. Neuromuscular jitter is an important measure that reflects the stability of the operation of a neuromuscular junction. It is conventionally measured using single fiber electromyographic (SFEMG) techniques. SFEMG techniques require substantial physician dexterity and subject cooperation. Furthermore, SFEMG needles are expensive, and their re-use increases the risk of possible transmission of infectious agents. Using disposable concentric needle (CN) electrodes and automating the measurment of neuromuscular jitter would greatly facilitate the study of neuromuscular disorders. An improved automated jitter measurment system based on the decomposition of CN detected EMG signals is developed and evaluated in this thesis. Neuromuscular jitter is defined as the variability of time intervals between two muscle fiber potentials (MFPs). Given the candidate motor unit potentials (MUPs) of a decomposed EMG signal, which is represented by a motor unit potential train (MUPT), the automated jitter measurement system designed in this thesis can be summarized as a three-step procedure: 1) identify isolated motor unit potentials in a MUPT, 2) detect the significant MFPs of each isolated MUP, 3) track significant MFPs generated by the same muscle fiber across all isolated MUPs, select typical MFP pairs, and calculate jitter. In Step one, a minimal spanning tree-based 2-phase clustering algorithm was developed for identifying isolated MUPs in a train. For the second step, a pattern recognition system was designed to classify detected MFP peaks. At last, the neuromuscular jitter is calculated based on the tracked and selected MFP pairs in the third step. These three steps were simulated and evaluated using synthetic EMG signals independently, and the whole system is preliminary implemented and evaluated using a small simulated data base. Compared to previous work in this area, the algorithms in this thesis showed better performance and great robustness across a variety of EMG signals, so that they can be applied widely to similar scenarios. The whole system developed in this thesis can be implemented in a large EMG signal decomposition system and validated using real data.