Integrated Design Fabrication and Control of a Bioinspired Multimaterial Soft Robotic Hand.

Machines that mimic humans have inspired scientists for centuries. Bioinspired soft robotic hands are a good example of such an endeavor, featuring intrinsic material compliance and continuous motion to deal with uncertainty and adapt to unstructured environments. Recent research led to impactful achievements in functional designs, modeling, fabrication, and control of soft robots. Nevertheless, the full realization of life-like movements is still challenging to achieve, often based on trial-and-error considerations from design to fabrication, consuming time and resources. In this study, a soft robotic hand is proposed, composed of soft actuator cores and an exoskeleton, featuring a multimaterial design aided by finite element analysis (FEA) to define the hand geometry and promote finger's bendability. The actuators are fabricated using molding, and the exoskeleton is 3D-printed in a single step. An ON-OFF controller keeps the set fingers' inner pressures related to specific bending angles, even in the presence of leaks. The FEA numerical results were validated by experimental tests, as well as the ability of the hand to grasp objects with different shapes, weights, and sizes. This integrated solution will make soft robotic hands more available to people, at a reduced cost, avoiding the time-consuming design-fabrication trial-and-error processes.

Perfil Clínico dos Pacientes Críticos Oncológicos com Covid-19 / Clinical Profile of Critical Oncological Patients with COVID-19 / Perfil Clínico de Pacientes Oncológicos Críticos con Covid-19

Introdução: A infecção por Sars-CoV-2 possui um amplo espectro clínico, que pode ser categorizado pelo seu nível de severidade. Ser paciente oncológico está descrito na literatura como fator de risco importante em níveis mais severos da doença decorrente do estado de imunossupressão. Objetivo: Comparar as características demográficas e clínicas entre pacientes oncológicos e não oncológicos com covid-19 em um hospital de referência na cidade de Belém, Pará. Método: Estudo retrospectivo e quantitativo de análise de prontuários de pacientes diagnosticados com covid-19 entre abril e julho de 2020. Para a análise dos dados, fez-se o cálculo do risco relativo com intervalo de confiança de 95% e teste t. Resultados: A amostra totalizou 53 pacientes da UTI diagnosticados com covid-19 e foi composta principalmente pelo sexo feminino (31; 58,49%). Houve predominância do desfecho óbito no grupo de pacientes oncológicos (27; 81,8%), assim como maior número de comorbidades não neoplásicas entre os pacientes oncológicos (19; 57,5%). Além disso, os pacientes oncológicos tiveram maior tempo de suporte ventilatório invasivo, com média de dez dias (13; 39,39%). Conclusão: Houve diferença nas características demográficas e nas intervenções realizadas entre os grupos estudados.

Introduction: SARS-CoV-2 infection has a broad clinical spectrum, which can be categorized by its level of severity. Being an oncological patient is described in the literature as an important risk factor for more severe levels of the disease resulting from a state of immunosuppression. Objective: To compare demographic and clinical characteristics among cancer and non-cancer patients with COVID-19 in a referral hospital in the city of Belém, Pará. Method: Retrospective and quantitative study of analysis of medical records of patients diagnosed with COVID-19 between April and July 2020. For data analysis, the relative risk was calculated with a 95% confidence interval and test t. Results: The sample consisted in 53, mostly females (31; 58.49%) ICU patients diagnosed with COVID-19. There was a predominance of the outcome death for the group of cancer patients (27; 81.8%), as well as a greater number of non-neoplastic comorbidities among cancer patients (19; 57.5%). Cancer patients had longer invasive ventilatory support, with a mean of ten days (13; 39.39%). Conclusion: There were differences in demographic characteristics and interventions performed among the groups investigated.

Introducción: La infección por Sars-CoV-2 tiene un amplio espectro clínico, que se puede categorizar según su nivel de gravedad. Ser un paciente oncológico se describe en la literatura como un importante factor de riesgo para niveles más severos de la enfermedad derivados de un estado de inmunosupresión. Objetivo: Comparar las características demográficas y clínicas entre pacientes oncológicos y no oncológicos con covid-19 en un hospital de referencia en la ciudad de Belém, Pará. Método: Estudio retrospectivo y cuantitativo de análisis de historias clínicas de pacientes diagnosticados con covid-19, entre abril y julio de 2020. Para el análisis de datos se calculó el riesgo relativo con un intervalo de confianza del 95% y test t. Resultados: La muestra totalizó 53 pacientes de UCI diagnosticados con covid-19 e estaba compuesta principalmente por el sexo femenino (31; 58,49%). Predominó el desenlace de muerte en el grupo de pacientes oncológicos (27; 81,8%), así como un mayor número de comorbilidades no neoplásicas entre los pacientes oncológicos (19; 57,5%). Los pacientes con cáncer tuvieron soporte ventilatorio invasivo por más tiempo, con una media de diez días (13; 39,39 %). Conclusión: Hubo diferencias en las características demográficas y en las intervenciones realizadas entre los grupos estudiados.

Comparative Trial of Continuous Flow Enteral and Intravenous Fluid Therapy in Horses.

Continuous flow enteral fluid therapy with isotonic and hypotonic enteral electrolyte solutions are as safe and effective as intravenous fluid therapy. The aim of this study was to carry out a comparative assessment between continuous flow enteral and intravenous (IV) fluid therapy in adult experimentally dehydrated horses. Six experimentally dehydrated adult mares were used in a study carried out in a 6 × 3 crossover design, which each animal received three different treatments (isotonic enteral fluid therapy-EsISO, hypotonic enteral fluid therapy-EsHYPO and intravenous fluid therapy with Lactate Ringer Solution-LR IV, all in continuous flow). Solutions were administered at a rate of 15 mL-1.kg-1.h-1 for 8 h, after 36 h of water and food deprivation. Serum and urinary biochemical assessment; urinary volume, pH and specific gravity; and blood gas analysis were measured at -36, 0, 2, 4, 6, and 8 h. The dehydration period (DP) caused discrete hydroelectrolytic and acid base imbalances. The EsISO, EsHYPO and LR IV increased blood volume. Enteral solutions restored the imbalances yielded by the DP and all treatments increased urine volume. Also, the EsHYPO and LR IV showed no effects in acid base balance, while EsISO showed slightly acidifying effect. The present study certifies the efficacy and safety of isotonic and hypotonic continuous flow enteral fluid therapy in comparison to IV fluid therapy in dehydrated horses.

Enteral electrolytic solutions administered in continuous flow via naso-ruminal route in adult goats.

This study aimed to investigate the effects of maintenance enteral electrolytic solutions administered naso-ruminally in continuous flow in adult goats subjected to water and food restriction. Six adult non-pregnant and non-lactating female goats, aged between two and five years old, were used in a crossover (6 × 2) study. Solution 1 (SEE1) comprised: 4.5 g sodium chloride (NaCl); 1 g potassium chloride (KCl); 0.5 g magnesium chloride (MgCl); 1 g calcium chloride in 1,000 ml of water (measured osmolarity: 202 mOsm/l). Solution 2 (SEE2) comprised: 4.5 g of NaCl; 1 g of KCl; 0.5 g of MgCl; 2 g of calcium acetate in 1,000 ml of water (measured osmolarity: 212 mOsm/l). The solutions were administered naso-ruminally at a dose rate of 15 ml/kg/hr, for 12 hr. The animals were evaluated at times T-24, T0, T4, T8, T12, and T24. Both enteral electrolytic solutions were effective in expanding blood volume. SEE1 showed a low-intensity acidifying potential, while SEE2 showed behavior of a neutral enteral electrolytic solution.

Effects of Hypotonic and Isotonic Enteral Electrolyte Solutions Administered in Continuous Flow in Weaned Foals.

The effects of fluid therapy with maintenance enteral electrolytic solutions administered by nasogastric route in continuous flow have not previously been studied in weaned foals. This study primary goal was to compare the effects of two maintenance enteral electrolytic solutions administered by nasogastric route in continuous flow on the hydro electrolytic balance in weaned foals. This paper was a controlled trial in a cross-over design (6 × 2) performed in six foals with a mean age of 7.3 ± 1.4 months; each animal received two treatments, IsoES and HypoES, with an interval of 7 days between treatments. After 12 h of fasting, the animals were treated with enteral electrolyte solutions administered via nasogastric route in continuous flow in a volume of 15 mL/kg/h for 12 h. The evaluations were performed at T-12h (the beginning of the fasting), T0h (end of fasting and beginning of fluid therapy), T4h (4 h of fluid therapy), T8h (8 h of fluid therapy), T12h (end of fluid therapy), and T24h (12 h after the end of fluid therapy). Twelve hours of fasting resulted in a reduction (P < 0.05) in body weight, abdominal circumference, whereas serum sodium, SID and enophthalmos increased. Twelve hours of fluid therapy normalized these parameters and promoted increased urinary volume and decreased urinary density without causing electrolyte imbalances. Both enteral electrolytic solutions were effective in reestablishing clinical and laboratorial variables without causing electrolyte imbalances.

Transition period produces changes in blood and body composition in mares / Período de transição produz alterações na composição do sangue e do corpo em éguas

Clinical and metabolic evaluation is necessary for the monitoring of pregnant and lactating mares, as they reflect the health of the animal. The body condition of the mare is an indicator of reproductive efficiency. The study aimed to determine the possible variations in body and metabolic condition in Mangalarga Marchador mares during the transition period. Forty-eight mares distributed in two groups were used: Maintenance Group (MG), composed of non-pregnant and non-lactating mares, and Transition Group (TG), formed by pregnant mares and who after delivery became lactating. Analyzes were performed in the times T-60, T-30 and T-15 before delivery, first six hours (T0) after delivery and T15, T30 and T60 days after delivery. MG was evaluated only at one time (T-60). Body weight and fat-free mass differed (P<0.05) between the groups. The percentage of fat was lower in MG. Mares had a higher fat percentage in TG at T-60 and T-30 times. There was a difference (P<0.05) in the amount of cholesterol between MG and TG (T0, T15 and T30). Triglycerides were different between the groups. TG showed higher concentrations of non-esterified fatty acids (P<0.05). There was a higher amount of glucose in TG (delivery and lactation) when compared to mares in MG. Changes in body condition and metabolic constituents occurred in the animals resulting from physiological adaptations of the transition period. The energetic components are the most affected from the transition period, with intense fat mobilization to supply the body demands.(AU)

Avaliações clínicas e metabólicas são necessárias para o monitoramento de éguas gestantes e lactantes, pois refletem a saúde do animal. A condição corporal da égua pode ser um indicador da eficiência reprodutiva. O estudo objetivou determinar as possíveis variações na condição corporal e metabólica em éguas Mangalarga Marchador durante o período de transição. Foram utilizadas 48 éguas distribuídas em dois grupos: Grupo em Manutenção (GM) composto por éguas não gestantes e não lactantes; Grupo em Transição (GT) formado por éguas gestantes e que após o parto tornaram-se lactantes. As análises foram realizadas nos tempos T-60, T-30 e T-15 antes do parto, primeiras seis horas (T0) após o parto e T15, T30 e T60 dias após o parto. O GM foi avaliado apenas uma vez (T-60). O peso corporal e a massa livre de gordura diferiram (P<0,05) entre os grupos. O percentual de gordura foi menor em GM. As éguas apresentaram maior porcentagem de gordura no GT no T-60 e no T-30. Houve diferença (P<0,05) na quantidade de colesterol entre GM e GT (T0, T15 e T30). Triglicérides foram diferentes entre os grupos. GT apresentou maiores concentrações de ácidos graxos não esterificados (P<0,05). Houve maior quantidade de glicose no GT (parto e lactação) quando comparada às éguas no GM. Mudanças na condição corporal e nos constituintes metabólicos ocorreram nos animais resultantes de adaptações fisiológicas do período de transição. Os componentes energéticos são os mais afetados neste período, existindo intensa mobilização de gordura para suprir demandas corporais.(AU)

Biochemical profile of Mangalarga Marchador mares during the last third of pregnancy, foaling and lactation / Perfil bioquímico de éguas da raça Mangalarga Marchador durante o terço final da gestação, parto e lactação

ABSTRACT: Adaptive changes in metabolism may occur under specific physiological conditions, being necessary the knowledge of the biochemical constituents that can undergo variations during the sixty days before foaling, until the first sixty days of lactation. The present study aimed to identify and evaluate the biochemical profile of Mangalarga Marchador mares during the last third of pregnancy, foaling and lactation. For this, 48 mares were used, which formed a maintenance group (MG), composed of non-pregnant mares and an experimental group, called the transition group (TG), formed by pregnant mares. Blood samples were collected at the following times: MG was evaluated in a single time (beginning of all collections); TG was evaluated in seven times [T-60, T-30, T-15 (days before foaling), T0 (first six hours after foaling), T15, T30, T60 (days after foaling)]. All animals were submitted to biochemical analysis, in which the concentrations of total calcium, chloride, phosphorus, magnesium, sodium, potassium, uric acid, creatinine, and urea were measured. The two groups differed significantly (P<0.05) in calcium, magnesium, sodium, potassium, creatinine, uric acid and urea concentration. Variation between times was also observed for these compounds. However, chloride and phosphorus did not differ between MG and TG. It was concluded that the last third of pregnancy, foaling and lactation exerts major influence on the biochemical constituents of blood through adjustments to maintain homeostasis in mares.

RESUMO: Mudanças adaptativas no metabolismo podem ocorrer em condições fisiológicas específicas, sendo necessário o conhecimento dos constituintes bioquímicos que possam sofrer variações durante os sessenta dias antes do parto, até os primeiros sessenta dias de lactação. O presente estudo teve como objetivo identificar e avaliar o perfil bioquímico de éguas Mangalarga Marchador no terço final da gestação, parto e lactação. Para isso, foram utilizadas 48 éguas, que formaram um grupo em manutenção (GM), composto por éguas não prenhes e um grupo experimental, chamado de grupo de transição (GT), formado por éguas gestantes. As coletas de sangue foram realizadas nos seguintes tempos: GM foi avaliada em um único tempo (início de todas as coletas); GT foi avaliado em sete tempos [T-60, T-30, T-15 (dias antes do parto), T0 (primeiras seis horas após o parto), T15, T30, T60 (dias após o parto)]. Todos animais foram submetidos as análises bioquímicas, em que foram mensuradas as concentrações de cálcio total, sódio, potássio, cloreto, fósforo, magnésio, ácido úrico, creatinina e ureia. Os dois grupos diferiram significativamente (P<0,05) nas concentrações de cálcio total, magnésio, sódio, potássio, creatinina, ácido úrico e ureia. Variações entre tempos também foram observadas nesses componentes. Entretanto, cloreto e fósforo não diferiram entre GM e GT. Conclui-se que o terço final da gestação, parto e lactação exerce forte influência sobre os constituintes bioquímicos do sangue por meio de ajustes para manter a homeostase nas éguas.

Two enteral solutions with different chloride concentrations administered by naso-ruminal route for fluid therapy in adult cattle / Comparação de duas soluções enterais com diferentes concentrações de cloreto administradas por via nasorruminal para hidratação em bovinos adultos

ABSTRACT: Six adult Holstein cows were used in this fluid therapy study. All animals were previously submitted to 24 hours of water and food abstaining period and submitted to both hydration treatments for eight hours in a crossover design 6x2. Two treatments with hypotonic solutions (190 mOsm/L) with low strong ion difference and different chloride concentrations solutions were executed. Physical, biochemical, blood gas analysis and urinary evaluation were executed in five different experimental times (T-24h, T0h, T4h, T8h e T24h). The hydration period caused plasmatic volume expansion. An increase in faeces humidity, excretion of Na+ and Cl- in urine, reduction of PCV, osmolarity, blood and urinary pH was observed. Both solutions can be used for fluid therapy for adult cattle and solution containing calcium chloride (SECaCl) was the most suitable for use in animals with hypochloraemia.

RESUMO: Seis vacas holandesas adultas foram utilizadas neste estudo de hidratação. Todos os animais foram submetidos previamente a 24 horas de jejum hídrico e alimentar e submetidos a ambos os tratamentos de hidratação por oito horas, em delineamento transversal 6x2. Foram realizados dois tratamentos com soluções hipotônicas balanceadas (190 mOsm/L) com diferentes concentrações de cloretos. Foram realizadas avaliações físicas, bioquímicas, hemogasometria e avaliação urinária em cinco diferentes tempos experimentais (T-24h, T0h, T4h, T8h e T24h). O período de hidratação causou expansão de volume plamático. Foi observado aumento da umidade das fezes e da excreção de Na+ e Cl- na urina, redução do volume globular, osmolaridade, pH sangüíneo e pH urinário. Ambas as soluções podem ser usadas para hidratação de bovinos adultos, sendo a solução que contém cloreto de cálcio (SECaCl) a mais indicada para o uso em animais com hipocloremia.

Lesão cervical não cariosa e hipersensibilidade dentinária: relato de caso clínico / Non-carious cervical lesions and dental hypersensitivity: a clinical case reportq

As lesões cervicais não cariosas (LCNC) caracterizam-se pela perda irreversível e gradual de tecido mineralizado junto da junção amelo-cementária, sem qualquer envolvimento bacteriano e é um dos fatores relacionados à hipersensibilidade dentinária (HD), caracterizado por uma dor aguda, provocada e de curta duração. Paciente L.C.M, sexo feminino, 38 anos de idade, compareceu à Clínica Odontológica da Faculdade Patos de Minas (FPM), relatando sensibilidade nos dentes 44 e 45. Após assinado o Termo de consentimento livre e esclarecido (TCLE), a paciente realizou tomadas radiográficas e foi submetida a anamnese e exame clínico, no qual, foi observada a presença de LCNC e diagnosticada como multifatorial. O ajuste oclusal foi realizado com pontas diamantadas e borrachas abrasivas removendo contatos prematuros. A restauração direta em resina composta foi indicada para a obliteração mecânica/física dos túbulos dentinários, como opção de tratamento. Foi realizado condicionamento ácido do esmalte, por 30seg e da dentina por 15seg, com ácido fosfórico 37% (Condac, FGM), lavado com água pelo mesmo tempo, seguido de controle de umidade e duas camadas de adesivo convencional (Ambar, FGM), fotoativando apenas a segunda camada por 20seg com LED (Kavo 1100 mW/cm²). A LCNC foi restaurada com resina composta convencional (A3E, Llis, FGM), com dois incrementos de aproximadamente 2mm cada, seguidas de acabamento e polimento. A hipersensibilidade foi cessada imediatamente logo após o ajuste oclusal e tratamento restaurador, ressaltando a importância do diagnóstico e do exame clínico. A remoção dos contatos prematuros e a restauração com resina composta foram essenciais para o sucesso deste tratamento, visto que a origem da perda mineral foi cessada concomitante com o alívio da dor.

The non-carious cervical lesions (NCCI) are characterized by the irreversible and gradual loss of mineralized tissue combined to the amelo-cementary junction, without any bacteria participation and is one of the factors related to dentin hypersensitivity (HD), classified by an acute pain, incited and in short term. Patient L.C.M, woman, 38 years old, attended to the Dental Clinic of Faculty Patos de Minas (FPM), reporting sensitivity on teeth 44 and 45. After signed the agreement form, the patient was submitted to an anamnesis, clinical exam and x-ray, in which, it was detected the presence of NCCL, diagnosed by multifactorial. Occlusal adjustment was performed with diamond and rubber tips removing the early contact area. The resin-composite restoration was recommended as a treatment option to physic and mechanically obliterate the dentin tubules. Enamel was etched for 30 sec and dentin for 15 sec with 37% phosphoric acid (Condac, FGM) and washed with water for 30 sec. Two layers of a dentin adhesive (Ambar, FGM) was applied and light cured for 20 sec with a LED light curing unit (Kavo 1100 mW / cm²). The NCCL was restored with a resin-composite (A3E, Llis, FGM), with two increments of approximately 2mm each, followed by a finishing and polishing protocol. The hypersensitivity was interrupted immediately after occlusal adjustment and restorative treatment, emphasizing the importance of diagnosis and clinical exam. Removal of premature contacts and restoration with composite resin were essential for the success of this treatment, since the origin of the mineral loss was controlled concomitantly with pain relief.

Enteral fluid therapy administered in continuous flow by naso-ruminal route using three maintenance electrolyte solutions: effects on physiological biomarkers and the hemogram of bovines / Hidratação enteral via nasorruminal em fluxo continuo utilizando três soluções eletrolíticas de manutenção: efeitos sobre os biomarcadores fisiológicos e o hemograma de bovinos

ABSTRACT: The aim of this study was to evaluate the effects of three enteral electrolyte solutions, each with different energy sources, administrated as continuous flow on the physiological parameters and blood count of healthy Holstein heifers. Six Holstein heifers were used in a crossover design. All animals received all three treatments: solution with calcium propionate, 4g of NaCl, 0.5g of KCl, 0.3g of MgCl2, and 10g of calcium propionate diluted in 1000mL of water (measured osmolarity: 299mOsm/L); solution with glycerol, 4g of NaCl, 0.5g of KCl, 0.3g of MgCl2, 1g of calcium acetate, and 10mL of glycerol in 1000mL of water (measured osmolarity: 287mOsm/L); solution with propylene glycol, 4g of NaCl, 0.5g of KCl, 0.3g of MgCl2, 1g of calcium acetate, and 15mL of propylene glycol in 1000mL of water (measured osmolarity: 378mOsm/L). Physical evaluations and blood samples were collected immediately before the initiation of fluid therapy, at 3-hour intervals over the 12-hour period of fluid therapy, and 12 hours after the end of fluid therapy. Animals presented no signs of stress or discomfort. All solutions resulted in a significant decrease in erythrocyte concentration, hemoglobin concentration, and hematocrit, without affecting the leukogram. Enteral fluid therapy administered as continuous flow via the naso-ruminal route was well-tolerated by animals with minimal effects on animal welfare, even when administered for 12 hours. This technique is indicated as an alternative route for parenteral maintenance fluid therapy. Electrolyte solutions proposed here were able to significantly expand blood volume.

RESUMO: Objetivou-se avaliar os efeitos de três soluções eletrolíticas enterais de manutenção com diferentes fontes de energia administradas em bovinos adultos por via nasorruminal em fluxo contínuo sobre parâmetros fisiológicos e hematológicos. Foram utilizadas seis novilhas holandesas em um delineamento crossover. Os animais foram submetidos a três tratamentos: Solução contendo Propionato de cálcio - 4g de NaCl, 0,5g de KCl, 0,3g de MgCl2 e 10g de propionato de cálcio para cada 1000mL (Osmolaridade mensurada: 299mOsm/L); Solução contendo Glicerol - 4g de NaCl, 0,5g de KCl, 0,3g de MgCl2, 1g de acetato de cálcio e 10mL de glicerol para cada 1000mL (Osmolaridade mensurada: 287mOsm/L); Solução contendo Propilenoglicol - 4g de NaCl, 0,5g de KCl, 0,3g de MgCl2, 1g de acetato de cálcio e 15mL de propilenoglicol para cada 1.000mL (Osmolaridade mensurada: 378mOsm/L). Foi realizado exame físico e colheita de sangue para os hemogramas imediatamente antes do início da hidratação e a cada três horas durante 12h de tratamento e mais uma colheita 12h após o final do período experimental, perfazendo seis colheitas ao total. Todas soluções promoveram ao longo das 12 horas de tratamento hemodiluição com redução nos valores de hemácias, concentração de hemoglobina e volume globular, sem, contudo, alterar o leucograma. A hidratação enteral em fluxo contínuo via nasorruminal, mostrou-se uma técnica bem tolerada pelos animais, como mínimos efeitos sobre o bem-estar, mesmo quando administrada por 12 horas, sendo, portanto, uma técnica indicada como uma opção à hidratação parenteral na terapia de manutenção de fluidos. As três soluções eletrolíticas aqui propostas são capazes de expandir significativamente a volemia.

Atypical 'benign behaviour' of eyelid sebaceous carcinoma.

Eyelid sebaceous carcinoma is a rare tumour with slow growth and it is one of the most aggressive malignancies of the eyelid. Death rate can reach 6%. The diagnosis is often delayed because it is confused with other periocular lesions. The authors describe a case with atypical presentation, regarding rapid growth rate and exophytic aspect. Female, 78 years, presenting lower eyelid tumour with 4 months of evolution. Ophthalmological examination showed a tarsal exophytic tumour (22 mm), non-adherent to bulbar conjunctiva. She was medicated topically for 3 months, with the diagnosis of chalazio. Total excision was performed for histological diagnosis. After diagnosis of sebaceous carcinoma with specific immunohistochemical markers, and without free tumour surgical limits, a second surgery was performed with a pentagon entire thickness excision. Being a rare tumour but with a considerable morbidity and mortality; early diagnosis and treatment is essential for a good prognosis and preservation of visual function.