A 3D Printed, Bionic Hand Powered by EMG Signals and Controlled by an Online Neural Network.

About 8% of the Ecuadorian population suffers some type of amputation of upper or lower limbs. Due to the high cost of a prosthesis and the fact that the salary of an average worker in the country reached 248 USD in August 2021, they experience a great labor disadvantage and only 17% of them are employed. Thanks to advances in 3D printing and the accessibility of bioelectric sensors, it is now possible to create economically accessible proposals. This work proposes the design of a hand prosthesis that uses electromyography (EMG) signals and neural networks for real-time control. The integrated system has a mechanical and electronic design, and the latter integrates artificial intelligence for control. To train the algorithm, an experimental methodology was developed to record muscle activity in upper extremities associated with specific tasks, using three EMG surface sensors. These data were used to train a five-layer neural network. the trained model was compressed and exported using TensorflowLite. The prosthesis consisted of a gripper and a pivot base, which were designed in Fusion 360 considering the movement restrictions and the maximum loads. It was actuated in real time thanks to the design of an electronic circuit that used an ESP32 development board, which was responsible for recording, processing and classifying the EMG signals associated with a motor intention, and to actuate the hand prosthesis. As a result of this work, a database with 60 electromyographic activity records from three tasks was released. The classification algorithm was able to detect the three muscle tasks with an accuracy of 78.67% and a response time of 80 ms. Finally, the 3D printed prosthesis was able to support a weight of 500 g with a safety factor equal to 15.

Emergency surgical treatment for active bleeding and anemia in patients with hemorrhoidal disease.

INTRODUCTION: The purpose of the study is to describe the clinical and surgical characteristics of patients with hemorrhoidal disease (HD), anemia, and active bleeding in need of urgent surgery. METHODS: It is a descriptive, retrospective study of 510 patients between 2015 and 2019. Male and female patients diagnosed with HD. The records of these patients were reviewed, and we identified those who underwent emergency surgery due to active bleeding, anemia, shock, and other clinical problems. Statistical analysis was carried out with the SPSS version 24 software. RESULTS: Fifty-three (10.3%) patients met the criteria for presenting active hemorrhoidal bleeding at the time of review and clinical and biochemical data of anemia. Patients presented a mean hemoglobin of 7.5 g/dl. The most frequent degree of HD was Grade II. The treatment received in 92.5% of the cases was hemorrhoidectomy with the Ferguson technique; in 5.7% (3), a hemorrhoidectomy was performed with an advanced energy device, and 1.9% (1) underwent the Milligan-Morgan technique. CONCLUSIONS: Emergency hemorrhoidectomy is the treatment of choice for patients with severe active bleeding from HD.

INTRODUCCIÓN: El propósito del estudio es describir las características clínicas y quirúrgicas de los pacientes con enfermedad hemorroidal, sangrado activo y anemia con necesidad de cirugía. METODOLOGÍA: Se trata de un estudio descriptivo y retrospectivo de 510 pacientes de ambos sexos diagnosticados con enfermedad hemorroidal entre 2015 y 2019. Se revisaron los expedientes de los pacientes sometidos a cirugía urgente con presencia de sangrado, anemia, choque y otros problemas clínicos. El análisis estadístico fue realizado con el software SPSS version 24. RESULTADOS: El 10.3% (53) de los pacientes fueron diagnosticados con sangrado hemorroidal activo al momento de la revisión y con datos clínicos y bioquímicos de anemia. El promedio de hemoglobina de estos fue de 7.5 g/dl. La enfermedad hemorroidal grado II fue la más frecuente. Se realizó hemorroidectomia tipo Ferguson en el 92.5% (49) de los casos; 5.7% (3) fueron operados con energía avanzada y solo 1.9% (1) con la técnica Milligan-Morgan. CONCLUSIONES: La hemorroidectomia de urgencia es el tratamiento de elección en el sangrado activo severo por enfermedad hemorroidal.

Phenotypic, Anatomical, and Diel Variation in Sugar Concentration Linked to Cell Wall Invertases in Common Bean Pod Racemes under Water Restriction.

The common bean (Phaseolus vulgaris L.) pod wall is essential for seed formation and to protect seeds. To address the effect of water restriction on sugar metabolism in fruits differing in sink strength under light-dark cycles, we used plants of cv. OTI at 100% field capacity (FC) and at 50% FC over 10 days at the beginning of pod filling. Water restriction intensified the symptoms of leaf senescence. However, pods maintained a green color for several days longer than leaves did. In addition, the functionality of pods of the same raceme was anatomically demonstrated, and no differences were observed between water regimes. The glucose and starch concentrations were lower than those of sucrose, independent of pod wall size. Remarkably, the fructose concentration decreased only under water restriction. The cell wall invertase activity was twofold higher in the walls of small pods than in those of large ones in both water regimes; similar differences were not evident for cytosolic or vacuolar invertase. Using bioinformatics tools, six sequences of invertase genes were identified in the P. vulgaris genome. The PvINVCW4 protein sequence contains substitutions for conserved residues in the sucrose-binding site, while qPCR showed that transcript levels were induced in the walls of small pods under stress. The findings support a promising strategy for addressing sink strength under water restriction.

[Clinical and electromyographic findings in patients with diabetic polyneuropathy]. / Manifestaciones clínicas y alteraciones electroneuromiográficas en pacientes con diabetes tipo 2 y polineuropatía.

BACKGROUND: Diabetic neuropathy represents a polyneuropathy with electrophiosiological alterations. Electroneuromyography (NMD) plays an important role in the evaluation of patient with diabetes mellitus type 2 (DM2) and doubtful neuropathy. OBJECTIVE: To determine clinical manifestations in patients with distal symmetrical sensory polyneuropathy (DSSP) and to correlate them with electromyographic alterations. MATERIAL AND METHODS: Transversal, analytical study. 138 patients over 18 years old, with DM2 and PSSD were selected. They underwent physical examination, laboratory studies and electromyography (EM) with 4-channel Nicolet electromyograph. Measures of central tendency and their dispersion were analyzed; data normality with Kolmogorov-Smirnov; Student's t test and Spearman's correlation. RESULTS: Thalar hyperkeratosis was the most frequent clinical finding in 103 (74%) patients. The most frequent symptoms were paresthesia in 132 (95.7%) patients and tingling in 93 (67.4%) patients. Exploration of superficial sensitivity determined neuropathy in 42 (30.4%) patients finding greater insensitivity in the medial plantar nerve territory. In the EM, the nerve with the greatest absent response was the left lateral plantar nerve in 51 (59%) patients. A significant correlation (p < 0.05) was found between the variables of EM with age, years of evolution and levels of glycated hemoglobin A1c. CONCLUSIONS: The higher the lack of glycemic control, the chronobiology of the patient and the time of illness, the greater the electromyographic affection.

INTRODUCCIÓN: la neuropatía diabética representa una polineuropatía con alteración electrofiosiológica. La electroneuromiografía (ENM) desempeña un papel importante en la evaluación del paciente con diabetes mellitus tipo 2 (DM2) y neuropatía dudosa. OBJETIVO: determinar las manifestaciones clínicas en pacientes con polineuropatía sensitiva simétrica distal (PSSD) y correlacionarlas con alteraciones electroneuromiográficas. MATERIAL Y MÉTODOS: estudio transversal, analítico. Se seleccionaron 138 pacientes mayores de 18 años, con DM2 y PSSD. Se les realizó exploración física, estudios de laboratorio y ENM con electromiógrafo Nicolet de 4 canales. Se analizaron las medidas de tendencia central y su dispersión; normalidad de datos con Kolmogorov-Smirnov; t de Student y correlación de Spearman. RESULTADOS: la hiperqueratosis talar fue el hallazgo clínico más frecuente en 74% de los pacientes. Los síntomas más frecuentes fueron parestesias en 95.7% y hormigueo en 67.4%. La exploración de sensibilidad superficial determinó neuropatía en 30.4%, encontrando mayor insensibilidad en el territorio del nervio plantar medial. En la ENM, el nervio con mayor respuesta ausente fue el plantar lateral izquierdo en 59%. Se encontró correlación significativa (p < 0.05) entre las variables electroneuromiograficas con la edad, años de evolución y niveles de hemoglobina glucosilada A1c (HbA1c). CONCLUSIONES: a mayor descontrol glucémico, cronobiología del paciente y tiempo del padecimiento, mayor es la afección electroneuromiográfica.

Venoms of Centruroides and Tityus species from Panama and their main toxic fractions.

The scorpionism in Panama is notorious for the confluence and coexistence of buthid scorpions from the genera Centruroides and Tityus. This communication describes an overview of the larger representative toxic venom fractions from eight dangerous buthid scorpion species of Panama: Centruroides (C. granosus, C. bicolor, C. limbatus and C. panamensis) and Tityus (T. (A.) asthenes, T. (A.) festae, T. (T.) cerroazul and T. (A.) pachyurus). Their venoms were separated by HPLC and the corresponding sub-fractions were tested for lethality effects on mice and insects. Many fractions toxic to either mice or insects, or both, were found and have had their molecular masses determined by mass spectrometry analysis. The great majority of the lethal components had a molecular mass close to 7000 Da, assumed to be peptides that recognize Na+-channels, responsible for the toxicity symptoms observed in other buthids scorpion venoms. A toxic peptide isolated from the venom of T. pachyurus was sequenced by Edman degradation, allowing the synthesis of nucleotide probe for cloning the correspondent gene. The mature toxin based on the cDNA sequencing has the C-terminal residue amidated, contains 62 amino acid packed by 4 disulfide linkages, with molecular mass of 7099.1 Da. This same toxic peptide seems to be present in scorpions of the species T. pachyurus collected in 5 different regions of Panama, although the overall HPLC profile is quite different. The most diverse neurotoxic venom components from the genus Centruroides were found in the species C. panamensis, whereas T. cerroazul was the one from the genus Tityus. The most common neurotoxins were observed in the venoms of T. festae, T. asthenes and T. pachyurus with closely related molecular masses of 7099.1 and 7332 Da. The information reported here is considered very important for future generation of a neutralizing antivenom against scorpions from Panama. Furthermore, it will contribute to the growing interest in using bioactive toxins from scorpions for drug discovery purposes.

Predicting Women's Utilization of Primary Care Mental Health Services in Mexico City.

OBJECTIVE: To analyze factors associated with and predicting Mexican women seeking primary care mental health services (PCMHS) and provide suggestions to increase PCMHS utilization. METHOD: We administered a questionnaire to (N = 456) female patients in Mexico City primary care clinics. We conducted chi-square analyses of seeking PCMHS and sociodemographic variables, perceptions of and experiences with PCMHS. Our results and literature review guided our logistic regression model. RESULTS: Women referred to a mental health provider (MHP; odds ratio [OR] = 10.81, 95% CI = 3.59-32.51), whose coping mechanisms included talking to a MHP (OR = 5.53, 95% CI = 2.10-14.53), whose primary worry is loneliness (OR = 8.15, 95% CI = 1.20-55.10), and those who follow doctor's orders; were more likely to seek PCMHS (OR = 0.28, 95% CI = 0.09-0.92). CONCLUSIONS: Primary care providers play a fundamental role in women's decisions to seek PCMHS. Proper referrals to PCMHS should be encouraged.

Genome-wide association study and admixture mapping identify different asthma-associated loci in Latinos: the Genes-environments & Admixture in Latino Americans study.

BACKGROUND: Asthma is a complex disease with both genetic and environmental causes. Genome-wide association studies of asthma have mostly involved European populations, and replication of positive associations has been inconsistent. OBJECTIVE: We sought to identify asthma-associated genes in a large Latino population with genome-wide association analysis and admixture mapping. METHODS: Latino children with asthma (n = 1893) and healthy control subjects (n = 1881) were recruited from 5 sites in the United States: Puerto Rico, New York, Chicago, Houston, and the San Francisco Bay Area. Subjects were genotyped on an Affymetrix World Array IV chip. We performed genome-wide association and admixture mapping to identify asthma-associated loci. RESULTS: We identified a significant association between ancestry and asthma at 6p21 (lowest P value: rs2523924, P < 5 × 10(-6)). This association replicates in a meta-analysis of the EVE Asthma Consortium (P = .01). Fine mapping of the region in this study and the EVE Asthma Consortium suggests an association between PSORS1C1 and asthma. We confirmed the strong allelic association between SNPs in the 17q21 region and asthma in Latinos (IKZF3, lowest P value: rs90792, odds ratio, 0.67; 95% CI, 0.61-0.75; P = 6 × 10(-13)) and replicated associations in several genes that had previously been associated with asthma in genome-wide association studies. CONCLUSIONS: Admixture mapping and genome-wide association are complementary techniques that provide evidence for multiple asthma-associated loci in Latinos. Admixture mapping identifies a novel locus on 6p21 that replicates in a meta-analysis of several Latino populations, whereas genome-wide association confirms the previously identified locus on 17q21.

Plasmodium inui infection reduces the efficacy of a simian immunodeficiency virus DNA vaccine in a rhesus macaque model through alteration of the vaccine-induced immune response.

Human immunodeficiency virus type 1 and malaria are co-endemic in many areas. We evaluated the effects of Plasmodium inui infection on the performance of a simian immunodeficiency virus (SIV) DNA vaccine. Rhesus macaques were infected with P. inui by transfusion of whole blood from a persistently infected animal. Animals with and animals without P. inui infection were then vaccinated 4 times with an SIV DNA vaccine encoding SIVgag, SIVpol, and SIVenv. Animals were subsequently challenged with thirty 50% rhesus monkey infectious doses of SIVmac251 6 weeks after the last vaccination. P. inui-infected immunized animals showed a significantly higher viral load than animals without P. inui infection (P = .010, by the Wilcoxon rank sum test). The higher viral loads in the P. inui-infected animals were durable and were observed at all sampling time points across the study (P = .00245, by the Wilcoxon rank test). The P. inui-infected animals also had correspondingly lower CD4(+) cell counts. There were fewer vaccine-specific CD4(+) and CD8(+) cells in the P. inui-infected animals, compared with uninfected animals. Of importance, P. inui infection seemed to decrease the number of CD8(+) cells that could proliferate or secrete interferon γ, although the number of CD8(+) cells capable of secreting tumor necrosis factor α following in vitro stimulation was increased. This study demonstrated that P. inui infection had an influence on the immune response to an SIV DNA vaccine and decreased the vaccine's efficacy.

[Nutritional status of the poor, marginalized adults of the Triqui ethnic group in Oaxaca, Mexico]. / Estado nutricional en la marginación y la pobreza de adultos triquis del estado de Oaxaca, México.

OBJECTIVES: To further understanding of the nutritional transition process by studying possible changes over time in the nutritional status of the Triqui ethnic group in the state of Oaxaca, Mexico. METHODS: A retrospective study was conducted using anthropometric data available from three prior studies (end of the 19th century, 1940, and 2002). Means and z scores for height, weight, and body mass index of Triqui adults were calculated using Frisancho reference data. Statistical analyses of the results were performed with Student's t and chi-square tests. Sociocultural information was collected through interviews and direct observations, as well as from the available literature. RESULTS: The height of Triqui adults has remained very low. A majority of Triqui women were found to be short or very short; this, coupled with the low level of education and high rates of illiteracy and monolingualism, is indicative of a culture that does not favor females. The appearance of overweight and obesity among the men studied in 2002, relative to those studied in 1940, is cause for concern. Overweight was also recorded among the women in 2002. CONCLUSIONS: Despite the limitations shared by all retrospective studies, these results confirm that the nutritional status of the Triquis is different now from what it was 60 years ago and that these changes are related to the cultural changes the group is experiencing. To further understand this epidemiologic phenomenon, where malnutrition and obesity coexist, cross-disciplinary studies are needed to analyze the biological, social, and cultural factors involved, so that culturally-appropriate measures can be adopted.

Estado nutricional en la marginación y la pobreza de adultos triquis del estado de Oaxaca, México / Nutritional status of the poor, marginalized adults of the Triqui ethnic group in Oaxaca, Mexico

OBJETIVOS: Estudiar los posibles cambios seculares en el estado nutricional de sujetos del grupo étnico triqui del estado de Oaxaca, México, para profundizar el conocimiento del proceso descrito como transición nutricional. MÉTODOS: A partir de los datos antropométricos de tres estudios realizados anteriormente en este grupo -a fines del siglo XIX, en 1940 y en 2002-, se calcularon los promedios y las puntuaciones z de la estatura, del peso y del índice de masa corporal (IMC) de adultos triquis, empleando los referentes de Frisancho. Los resultados numéricos se analizaron estadísticamente mediante las pruebas de la t de Student y la x². La información sociocultural se obtuvo a través de entrevistas y de observación directa, así como de fuentes bibliográficas. RESULTADOS: La estatura de los triquis se ha mantenido muy baja. Se encontró un mayor número de mujeres de estatura pequeña o muy pequeña. Esto, sumado a la menor escolaridad y el mayor grado de analfabetismo y de monolingüismo de las mujeres, refleja una actitud cultural que no favorece al género femenino. Resulta preocupante la aparición de casos de sobrepeso y obesidad entre los hombres estudiados en 2002 con respecto a los incluidos en el estudio de 1940; en 2002 también las mujeres presentaron sobrepeso. CONCLUSIONES: A pesar de las limitaciones de todo estudio retrospectivo, los resultados obtenidos confirman que actualmente el estado nutricional de los triquis es diferente al de hace 60 años, en relación con los cambios culturales que está viviendo este grupo étnico. Para profundizar el conocimiento de este fenómeno epidemiológico en el que coexisten la desnutrición y la obesidad, es preciso realizar estudios transdisciplinarios que consideren la interacción de componentes biológicos, sociales y culturales interpretados en perspectiva sistémica, para adoptar medidas integrales teniendo presente las particularidades bioculturales de cada grupo humano.

OBJECTIVES: To further understanding of the nutritional transition process by studying possible changes over time in the nutritional status of the Triqui ethnic group in the state of Oaxaca, Mexico. METHODS: A retrospective study was conducted using anthropometric data available from three prior studies (end of the 19th century, 1940, and 2002). Means and z scores for height, weight, and body mass index of Triqui adults were calculated using Frisancho reference data. Statistical analyses of the results were performed with Student's t and chi-square tests. Sociocultural information was collected through interviews and direct observations, as well as from the available literature. RESULTS: The height of Triqui adults has remained very low. A majority of Triqui women were found to be short or very short; this, coupled with the low level of education and high rates of illiteracy and monolingualism, is indicative of a culture that does not favor females. The appearance of overweight and obesity among the men studied in 2002, relative to those studied in 1940, is cause for concern. Overweight was also recorded among the women in 2002. CONCLUSIONS: Despite the limitations shared by all retrospective studies, these results confirm that the nutritional status of the Triquis is different now from what it was 60 years ago and that these changes are related to the cultural changes the group is experiencing. To further understand this epidemiologic phenomenon, where malnutrition and obesity coexist, cross-disciplinary studies are needed to analyze the biological, social, and cultural factors involved, so that culturally-appropriate measures can be adopted.