ADAM: a robotic companion for enhanced quality of life in aging populations.

One of the major problems of today's society is the rapid aging of its population. Life expectancy is increasing, but the quality of life is not. Faced with the growing number of people who require cognitive or physical assistance, new technological tools are emerging to help them. In this article, we present the ADAM robot, a new robot designed for domestic physical assistance. It mainly consists of a mobile base, two arms with grippers and vision systems. All this allows the performance of physical tasks that require navigation and manipulation of the environment. Among ADAM's features are its modularity, its adaptability to indoor environments and its versatility to function as an experimental platform and for service applications. In addition, it is designed to work respecting the user's personal space and is collaborative, so it can learn from experiences taught by them. We present the design of the robot as well as examples of use in domestic environments both alone and in collaboration with other domestic platforms, demonstrating its potential.

Early adjunctive methylene blue in patients with septic shock: a randomized controlled trial.

PURPOSE: Methylene blue (MB) has been tested as a rescue therapy for patients with refractory septic shock. However, there is a lack of evidence on MB as an adjuvant therapy, its' optimal timing, dosing and safety profile. We aimed to assess whether early adjunctive MB can reduce time to vasopressor discontinuation in patients with septic shock. METHODS: In this single-center randomized controlled trial, we assigned patients with septic shock according to Sepsis-3 criteria to MB or placebo. Primary outcome was time to vasopressor discontinuation at 28 days. Secondary outcomes included vasopressor-free days at 28 days, days on mechanical ventilator, length of stay in ICU and hospital, and mortality at 28 days. RESULTS: Among 91 randomized patients, forty-five were assigned to MB and 46 to placebo. The MB group had a shorter time to vasopressor discontinuation (69 h [IQR 59-83] vs 94 h [IQR 74-141]; p < 0.001), one more day of vasopressor-free days at day 28 (p = 0.008), a shorter ICU length of stay by 1.5 days (p = 0.039) and shorter hospital length of stay by 2.7 days (p = 0.027) compared to patients in the control group. Days on mechanical ventilator and mortality were similar. There were no serious adverse effects related to MB administration. CONCLUSION: In patients with septic shock, MB initiated within 24 h reduced time to vasopressor discontinuation and increased vasopressor-free days at 28 days. It also reduced length of stay in ICU and hospital without adverse effects. Our study supports further research regarding MB in larger randomized clinical trials. Trial registration ClinicalTrials.gov registration number NCT04446871 , June 25, 2020, retrospectively registered.

Significant Rise in SARS-CoV-2 Reinfection Rate in Vaccinated Hospital Workers during the Omicron Wave: A Prospective Cohort Study.

Background: Relatively low SARS-CoV-2 reinfection rates have been reported in vaccinated individuals, but updates considering the Omicron variant are lacking. Objectives: The objective of the study was to provide a current estimate of the SARS-CoV-2 reinfection rate in a highly immunized population. Methods: A prospective cohort of Mexican hospital workers was followed (March 2020-February 2022). Reinfection was defined as the occurrence of two or more episodes of COVID-19 separated by a period of ≥ 90 days without symptoms. The reinfection rate was calculated as the number of reinfection episodes per 100,000 persons per day. Results: A total of 3732 medical consultations were provided to 2700 workers, of whom 1388 (51.4%) were confirmed COVID-19 cases. A total of 73 reinfection cases were identified, of whom 71 (97.3%) had completed their primary vaccination series and 22 (30.1%) had had a booster dose before the second episode. The overall reinfection rate was 23.1 per 100,000 persons per day (as compared to a rate of 1.9 per 100,000 persons per day before the Omicron wave). Conclusions: The SARS-CoV-2 reinfection rate rose significantly during the Omicron wave despite a high primary vaccination coverage rate. Almost one-third of reinfected workers had a vaccine booster ≥ 14 days before the last COVID-19 episode.

Significant Rise in SARS-CoV-2 Reinfection Rate in Vaccinated Hospital Workers during the Omicron Wave: A Prospective Cohort Study

ABSTRACT Background: Relatively low SARS-CoV-2 reinfection rates have been reported in vaccinated individuals, but updates considering the Omicron variant are lacking. Objective: The objective of the study was to provide a current estimate of the SARS-CoV-2 reinfection rate in a highly immunized population. Methods: A prospective cohort of Mexican hospital workers was followed (March 2020-February 2022). Reinfection was defined as the occurrence of two or more episodes of COVID-19 separated by a period of ≥ 90 days without symptoms. The reinfection rate was calculated as the number of reinfection episodes per 100,000 persons per day. Results: A total of 3732 medical consultations were provided to 2700 workers, of whom 1388 (51.4%) were confirmed COVID-19 cases. A total of 73 reinfection cases were identified, of whom 71 (97.3%) had completed their primary vaccination series and 22 (30.1%) had had a booster dose before the second episode. The overall reinfection rate was 23.1 per 100,000 persons per day (as compared to a rate of 1.9 per 100,000 persons per day before the Omicron wave). Conclusions: The SARS-CoV-2 reinfection rate rose significantly during the Omicron wave despite a high primary vaccination coverage rate. Almost one-third of reinfected workers had a vaccine booster ≥ 14 days before the last COVID-19 episode.

Multi-LiDAR Mapping for Scene Segmentation in Indoor Environments for Mobile Robots.

Nowadays, most mobile robot applications use two-dimensional LiDAR for indoor mapping, navigation, and low-level scene segmentation. However, single data type maps are not enough in a six degree of freedom world. Multi-LiDAR sensor fusion increments the capability of robots to map on different levels the surrounding environment. It exploits the benefits of several data types, counteracting the cons of each of the sensors. This research introduces several techniques to achieve mapping and navigation through indoor environments. First, a scan matching algorithm based on ICP with distance threshold association counter is used as a multi-objective-like fitness function. Then, with Harmony Search, results are optimized without any previous initial guess or odometry. A global map is then built during SLAM, reducing the accumulated error and demonstrating better results than solo odometry LiDAR matching. As a novelty, both algorithms are implemented in 2D and 3D mapping, overlapping the resulting maps to fuse geometrical information at different heights. Finally, a room segmentation procedure is proposed by analyzing this information, avoiding occlusions that appear in 2D maps, and proving the benefits by implementing a door recognition system. Experiments are conducted in both simulated and real scenarios, proving the performance of the proposed algorithms.

Effects on Behavior by Different Exposure Durations of Predator Scent Stress / Efectos Conductuales por Exposición a Diferentes Duraciones de Estrés por Olor de Depredador

Abstract Stress is conceptualized as a systemic response triggered by a stimulus potentially harmful to an organism. Instead of an adaptive outcome, life-threatening experiences may contribute to the development of anxiety disorders and depression. Predator scent stress (PSS) is one of the most utilized rodent models of stress-induced psychopathology, in which rodents are exposed to a volatile predator cue that signifies imminent danger. It is unclear if the duration of a life-threatening experience could have differential consequences on the expression of anxiety-like and depression-like behaviors. For this reason, the goal of this present study was to evaluate the effect of different exposure durations (3 min., 10 min., or 20 min.) to the scent of bobcat urine. Wistar rats housed under 12/12 dark cycle in standard laboratory conditions were exposed to the PSS model and 24 hrs. after the stressor, behavioral consequences were evaluated in the open field test, saccharin preference test, and forced swim test. The results obtained show that a 10-minute exposure is sufficient to induce an anxiety-like and a depression-like behavioral profile. We conclude that the time exposure could be a major variable to obtain clear and trustable results and to avoid overexposure to stressor.

Resumen El estrés es una respuesta sistémica desencadenada por un estímulo potencialmente peligroso para el organismo. Esta respuesta permite al organismo adaptarse a la condición estresante, sin embargo, experiencias que amenazan a la vida pueden incrementar el riesgo de desarrollar trastornos de ansiedad y depresión. La exposición al olor de depredador (EOD) es el modelo animal de patología inducida por estrés más utilizado. Consta de la exposición a una pista olfativa que significa peligro inminente. Aún no está claro si la duración a una experiencia que amenaza la vida puede generar diferencias en la expresión conductas tipo-ansiedad o tipo-depresión. Por esta razón, el objetivo de este estudio fue evaluar el efecto de diferentes duraciones de exposición (3 min., 10 min. o 20 min.) al aroma de lince. Se utilizaron ratas hembra de la cepa Wistar en un ciclo luz oscuridad 12/12 en condiciones estándar de laboratorio, los sujetos fueron evaluados en la prueba de campo abierto, preferencia de sacarina y nado forzado 24 hrs. después de terminado el estresor. Los resultados indican que la exposición a 10 min. es suficiente para inducir el perfil conductual tipo-depresión y tipo-ansiedad. Concluimos que el tiempo de exposición puede ser una variable de mayor importancia para obtener resultados confiables y prevenir exposiciones innecesarias al estrés.

Timing, method and discontinuation of hydrocortisone administration for septic shock patients.

AIM: To characterize the prescribing patterns for hydrocortisone for patients with septic shock and perform an exploratory analysis in order to identify the variables associated with better outcomes. METHODS: This prospective cohort study included 59 patients with septic shock who received stress-dose hydrocortisone. It was performed at 2 critical care units in academic hospitals from June 1st, 2015, to July 31st, 2016. Demographic data, comorbidities, medical management details, adverse effects related to corticosteroids, and outcomes were collected after the critical care physician indicated initiation of hydrocortisone. Univariate comparison between continuous and bolus administration of hydrocortisone was performed, including multivariate analysis, as well as Kaplan-Meier analysis to compare the proportion of shock reversal at 7 d after presentation. Receiver operating characteristic (ROC) curves determined the best cut-off criteria for initiation of hydrocortisone associated with the highest probability of shock reversal. We addressed the effects of the taper strategy for discontinuation of hydrocortisone, noting risk of shock relapse and adverse effects. RESULTS: All-cause 30-d mortality was 42%. Hydrocortisone was administered as a continuous infusion in 54.2% of patients; time to reversal of shock was 49 h longer in patients who were given a bolus administration [59 h (range, 47.5-90.5) vs 108 h (range, 63.2-189); P = 0.001]. The maximal dose of norepinephrine after initiation of hydrocortisone was lower in patients on continuous infusion [0.19 µg/kg per minute (range, 0.11-0.28 µg)] compared with patients who were given bolus [0.34 µg/kg per minute (range, 0.16-0.49); P = 0.004]. Kaplan-Meier analysis revealed a higher proportion of shock reversal at 7 d in patients with continuous infusion compared to those given bolus (83% vs 63%; P = 0.004). There was a good correlation between time to initiation of hydrocortisone and time to reversal of shock (r = 0.80; P < 0.0001); ROC curve analysis revealed that the best criteria for prediction of shock reversal was a time to initiation of hydrocortisone of ≤ 13 h after administration of norepinephrine, with an area under the curve of 0.81 (P < 0.001). The maximal dose of norepinephrine at initiation of hydrocortisone with the highest association with shock reversal was ≤ 0.28 µg/kg per minute, with an area under the curve of 0.75 (P = 0.0002). On a logistic regression model, hydrocortisone taper was not associated with a lower risk of shock relapse (RR = 1.29; P = 0.17) but was related to a higher probability of hyperglycemia [odds ratio (OR), 5.3; P = 0.04] and hypokalemia (OR = 10.6; P = 0.01). CONCLUSION: Continuous infusion of hydrocortisone could hasten the resolution of septic shock compared to bolus administration. Earlier initiation corresponds with a higher probability of shock reversal. Tapering strategy is unnecessary.

Estudio de las modificaciones de las hormonas corticosuprarrenales en el período de convalencia del infarto de miocardio / Study of the odifications of adrenocortical hormones during convalence period of myocardial infarction

Se estudian las concentraciones de cortisol y aldosterona en 22 pacientes de infarto del miocardio por el método de radioinmunoensayo [in vitro], con hormonas marcadas con I125. Se realizaron determinaciones en los meses 1ro, 2do, 3ro y 12mo de ocurrido el mismo, así como a un grupo control. Se señala que las concentraciones de cortisol que estaban elevadas al final del período agudo, disminuyeron en el 2do mes para luego aumentar de nuevo a fines del 3ro. Se plantea que al año las cifras eran similares a las del grupo control. Se informa que la aldosterona, que se elevó en el período agudo, tiende a disminuir en el 2do mes para luego aumentar en el 3ro. Se indica que las cifras al año eran ligeramente superiores al grupo control. Se discuten y comparan los resultados obtenidos con los encontrados en la bibliografía (AU)

Estudio de las modificaciones de las hormonas corticosuprarrenales en el período de convalencia del infarto de miocardio / Study of the modifications of adrenocortical hormones during convalence period of myocardial infarction

Se estudian las concentraciones de cortisol y aldosterona en 22 pacientes de infarto del miocardio por el método de radioinmunoensayo [in vitro], con hormonas marcadas con I125. Se realizaron determinaciones en los meses 1ro, 2do, 3ro y 12mo de ocurrido el mismo, así como a un grupo control. Se señala que las concentraciones de cortisol que estaban elevadas al final del período agudo, disminuyeron en el 2do mes para luego aumentar de nuevo a fines del 3ro. Se plantea que al año las cifras eran similares a las del grupo control. Se informa que la aldosterona, que se elevó en el período agudo, tiende a disminuir en el 2do mes para luego aumentar en el 3ro. Se indica que las cifras al año eran ligeramente superiores al grupo control. Se discuten y comparan los resultados obtenidos con los encontrados en la bibliografía

Valoración radionuclídica in vitro de la concentración plasmática de AMP-cíclico en pacientes con infarto cardíaco / In vitro radionuclide assessent of plasma cyclic AMP concentration in patients with cardiac infarction

Se realizó la determinación de los valores de AMP-cíclico plasmático en 19 pacientes con el diagnóstico confirmado de infarto cardíaca agudo, en los cuales no existían antecedentes conocidos de trastornos endocrinos; el rango de edad fue de 36 a 80 años y ambos sexos, donde predomina el masculino. El estudio se realizó en el período de 21 días posteriores a la fecha de ingreso. El AMP-cíclico fue valorado en plasma por el método radionuclídico con reactivos de la firma Amersham y como marcador del nucleótido, el tritio (8 - H3 adenosin 3,5; fosfato cíclico). Los niveles de AMP-cíclico se encuentran aumentados durante los 21 días posteriores al infarto en el grupo estudiado. En la primera semana en siete casos el promedio fue de X + 29,40 + ou - 1,4 mol/I, lo que difiere significativamente con el control (P <0.005). En la segunda semana X + 37,7 + ou - 2,35 n mol/I (P <0.005) y en la tercera semana el promedio fue X + 27,50 + ou - 4,09 n mol/I, sin encontrarse diferencia (P > 0.05). Grupo control X + 22,50 + ou - 1,00 n mol/I. Se discuten estos resultados y los datos obtenidos fueron estadísticamente precesados (AU)

Valoración radionuclídica in vitro de la concentración plasmática de AMP-cíclico en pacientes con infarto cardíaco / In vitro radionuclide assessment of plasma cyclic AMP concentration in patients with cardiac infarction

Se realizó la determinación de los valores de AMP-cíclico plasmático en 19 pacientes con el diagnóstico confirmado de infarto cardíaca agudo, en los cuales no existían antecedentes conocidos de trastornos endocrinos; el rango de edad fue de 36 a 80 años y ambos sexos, donde predomina el masculino. El estudio se realizó en el período de 21 días posteriores a la fecha de ingreso. El AMP-cíclico fue valorado en plasma por el método radionuclídico con reactivos de la firma Amersham y como marcador del nucleótido, el tritio (8 - H3 adenosin 3,5; fosfato cíclico). Los niveles de AMP-cíclico se encuentran aumentados durante los 21 días posteriores al infarto en el grupo estudiado. En la primera semana en siete casos el promedio fue de X + 29,40 + ou - 1,4 mol/I, lo que difiere significativamente con el control (P <0.005). En la segunda semana X + 37,7 + ou - 2,35 n mol/I (P <0.005) y en la tercera semana el promedio fue X + 27,50 + ou - 4,09 n mol/I, sin encontrarse diferencia (P > 0.05). Grupo control X + 22,50 + ou - 1,00 n mol/I. Se discuten estos resultados y los datos obtenidos fueron estadísticamente precesados