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Patel S.,Harvard University | Hughes R.,Harvard University | Hester T.,University of Texas at Austin | Stein J.,Columbia and Cornell Universities | And 3 more authors.
Proceedings of the IEEE

Quantitative assessment of motor abilities in stroke survivors can provide valuable feedback to guide clinical interventions. Numerous clinical scales were developed in the past to assess levels of impairment and functional limitation in individuals after stroke. The Functional Ability Scale is one of these clinical scales. It is a 75-point scale used to evaluate the functional ability of subjects by grading movement quality during performance of 15 motor tasks. Performance of these motor tasks requires subjects to reach for objects (e.g., a pencil on a table) and manipulate them (e.g., lift the pencil). In this paper, we show that accelerometer data recorded during performance of a subset of the motor tasks pertaining to the Functional Ability Scale can be relied upon to derive accurate estimates of the scores provided by a clinician using this scale. Accelerometer-based estimates of clinical scores were obtained by segmenting the recordings into movement components (reaching, manipulation, release/return), extracting data features, selecting features that maximized the separation among classes associated with different clinical scores, feeding these features to Random Forests to estimate scores for individual motor tasks, and using a linear equation to estimate the total Functional Ability Scale score based on the sum of the clinical scores for individual motor tasks derived from the accelerometer data. Results showed that it is possible to achieve estimates of the total Functional Ability Scale score marked by a bias of only 0.04 points of the scale and a standard deviation of only 2.43 points when using as few as three sensors to collect data during performance of only six motor tasks. © 2006 IEEE. Source

Vasile J.V.,Center for Microsurgical Breast Reconstruction | Newman T.,Weill Cornell Imaging at New York Presbyterian | Rusch D.G.,Drucker | Greenspun D.T.,Greenwich Hospital | And 3 more authors.
Journal of Reconstructive Microsurgery

Preoperative imaging is essential for abdominal perforator flap breast reconstruction because it allows for preoperative perforator selection, resulting in improved operative efficiency and flap design. The benefits of visualizing the vasculature preoperatively also extend to gluteal artery perforator flaps. Initially, our practice used computed tomography angiography (CTA) to image the gluteal vessels. However, with advances in magnetic resonance imaging angiography (MRA), perforating vessels of 1-mm diameter can reliably be visualized without exposing patients to ionizing radiation or iodinated intravenous contrast. In our original MRA protocol to image abdominal flaps, we found the accuracy of MRA compared favorably with CTA. With our increased experience with MRA, we decided to use MRA to image gluteal flaps. Technical changes were made to the MRA protocol to improve image quality and extend the field of view. Using our new MRA protocol, we can image the vasculature of the buttock, abdomen, and upper thigh in one study. We have found that the spatial resolution of MRA is sufficient to accurately map gluteal perforating vessels, as well as provide information on vessel caliber and course. This article details our experience with preoperative imaging for gluteal perforator flap breast reconstruction. © 2009 by Thieme Medical Publishers, Inc. Source

Jacono A.A.,North Shore University Hospital | Jacono A.A.,Yeshiva University | Malone M.H.,Columbia and Cornell Universities
Aesthetic Surgery Journal

Background Facial aging is a complicated process that includes volume loss and soft tissue descent. This study provides quantitative 3-dimensional (3D) data on the long-term effect of vertical vector deep-plane rhytidectomy on restoring volume to the midface. Objective To determine if primary vertical vector deep-plane rhytidectomy resulted in long-term volume change in the midface. Methods We performed a prospective study on patients undergoing primary vertical vector deep-plane rhytidectomy to quantitate 3D volume changes in the midface. Quantitative analysis of volume changes was made using the Vectra 3D imaging software (Canfield Scientific, Inc, Fairfield, New Jersey) at a minimum follow-up of 1 year. Results Forty-three patients (86 hemifaces) were analyzed. The average volume gained in each hemi-midface after vertical vector deep-plane rhytidectomy was 3.2 mL. Conclusions Vertical vector deep-plane rhytidectomy provides significant long-term augmentation of volume in the midface. These quantitative data demonstrate that some midface volume loss is related to gravitational descent of the cheek fat compartments and that vertical vector deep-plane rhytidectomy may obviate the need for other volumization procedures such as autologous fat grafting in selected cases. © 2015 The American Society for Aesthetic Plastic Surgery, Inc. Source

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