Testing the Limit Range of Motion Safety Function of Upper Limb Rehabilitation Robots with an Anthropometrically Adjustable and Sensorized Dummy Limb.

Arm type or exoskeleton type rehabilitation robots move the patient's upper limb through one or more, either free or restrained connection points. The rehabilitation robot is unsafe if it moves the patient's upper limb beyond the limits of the anatomical joint ranges. A validation toolkit was developed to assess the risks of "limit anatomical joint range of movement" and "limit anatomical joint overreaching" during the regular operation of a rehabilitation robot. The validation toolkit includes an anthropometrically adjustable and sensorised dummy limb attached to the RACA (rehabilitation, assessment, compensation, or alleviation) rehabilitation robot; and a software tool for off-line risk assessment and reporting.

Retraction Note: Insomnia, sleepiness, anxiety and depression among different types of gamers in African countries.

This Article has been retracted.

Evaluating Native Bee Communities and Nutrition in Managed Grasslands.

Native pollinators are important for providing vital services in agroecosystems; however, their numbers are declining globally. Bees are the most efficient and diverse members of the pollinator community; therefore, it is imperative that management strategies be implemented that positively affect bee community composition and health. Here, we test responses of the bee and flowering plant communities to land management treatments in the context of grasslands in the upper Midwestern United States, a critical area with respect to bee declines. Twelve sites were selected to examine floral resources and wild bee communities based on three different types of grasslands: tallgrass prairie remnants, ungrazed restorations, and grazed restorations. Total bee abundance was significantly higher in ungrazed restorations than remnants, but there were no significant differences among grasslands in community composition or Shannon diversity. Across the three grassland types we also examined mass and lipid stores as nutritional health indicators in three sweat bees (Halictidae), Augochlora pura, Agapostemon virescens, and Halictus ligatus. Although there were no differences in lipid content, total average bee mass was significantly higher in Ag. virescens collected from ungrazed restorations as compared to remnants. Floral abundance of native and non-native species combined was significantly higher in grazed restorations compared to remnants and ungrazed restorations. However, ungrazed restorations had higher abundance and richness of native flowering ramets. These data suggest that bee abundance and nutrition are driven by high abundance of native flowering plant species, rather than total flowering plants.

Insomnia, sleepiness, anxiety and depression among different types of gamers in African countries.

Gaming has increasingly become a part of life in Africa. Currently, no data on gaming disorders or their association with mental disorders exist for African countries. This study for the first time investigated (1) the prevalence of insomnia, excessive daytime sleepiness, anxiety and depression among African gamers, (2) the association between these conditions and gamer types (i.e., non-problematic, engaged, problematic and addicted) and (3) the predictive power of socioeconomic markers (education, age, income, marital status, employment status) on these conditions. 10,566 people from 2 low- (Rwanda, Gabon), 6 lower-middle (Cameroon, Nigeria, Morocco, Tunisia, Senegal, Ivory Coast) and 1 upper-middle income countries (South Africa) completed online questionnaires containing validated measures on insomnia, sleepiness, anxiety, depression and gaming addiction. Results showed our sample of gamers (24 ± 2.8 yrs; 88.64% Male), 30% were addicted, 30% were problematic, 8% were engaged and 32% were non-problematic. Gaming significantly contributed to 86.9% of the variance in insomnia, 82.7% of the variance in daytime sleepiness and 82.3% of the variance in anxiety [p < 0.001]. This study establishes the prevalence of gaming, mood and sleep disorders, in a large African sample. Our results corroborate previous studies, reporting problematic and addicted gamers show poorer health outcomes compared with non-problematic gamers.

Popliteal Artery Entrapment Syndrome.

¼ Popliteal artery entrapment syndrome is a commonly misdiagnosed condition that should be considered in patients presenting with exertional lower-extremity pain. ¼ In addition to a focused physical examination, the ankle-brachial index and advanced imaging consisting of computed tomography and computed tomographic angiography or magnetic resonance imaging and magnetic resonance angiography are crucial in evaluating the underlying cause of entrapment. ¼ Consultation with a vascular surgeon or team is necessary when planning surgical treatment of popliteal artery entrapment syndrome.

Orthopaedic metallic artefact reduction algorithm facilitates CT evaluation of the urinary tract after hip prosthesis.

AIM: To examine the improvement in the visualisation of bladder and ureteric pathologies next to a hip prosthesis with metallic artefact reduction for orthopaedic implants (O-MAR). MATERIALS AND METHODS: Thirty-four patients who underwent pelvic computed tomography (CT) for non-prosthesis-related causes were enrolled retrospectively. Portal venous phase scans were reconstructed both with standard iterative reconstruction (ITR) and with O-MAR. The density of the ureters and the bladder was measured at both sides in the plane of the prosthesis. A semi-quantitative score was also used to assess visibility. The R (version 3.4.1) package was used for statistical analysis. RESULTS: The average (µ) density of the 41 prosthesis side ureters was significantly lower on ITR images (µ=-94.76±150.48 [±SD] HU) than on O-MAR images (µ=-13.40±36.37 HU; p<0.0004). The difference between the ITR and O-MAR (µ=-138.62±182.64 versus -35.55±40.21 HU; p<0.0003) was also significant at the prosthesis side of the bladder. The visibility of the prosthesis side ureters was improved: 53.7% was obscured on ITR series compared to 4.9% on O-MAR. The visibility score was also better across all levels (p<0.001) with O-MAR. In four cases (13%), the O-MAR images significantly changed the diagnosis: in two cases ureteric stones, in one case each a bladder stone and a bladder tumour were discovered. CONCLUSIONS: O-MAR reconstruction of CT images significantly improves the visibility of the urinary tract adjacent to metallic hip implants. Thus, O-MAR is essential for detecting ureteric and bladder pathologies in patients with a hip prosthesis.

Characterization of Pasteurella multocida strains isolated from human infections.

Isolates of Pasteurella multocida recovered from infected humans (n = 15) were characterized by traditional and molecular microbiological methods and were compared with cat-derived strains (n = 5). The most prevalent subspecies among strains from human infections was P. multocida subsp. septica (80%), and nearly all isolates showed a similar combination of virulence-associated genes. MLST analysis classified the 20 P. multocida strains into 16 different sequence types, and we assigned 11 new sequence types (ST), however, only one of those (ST 334) was shared by two human and one cat isolates. P. multocida subsp. septica strains formed a distinct phylogenetic group within the species. The strains showed resistance to erythromycin, clindamycin and sulfamethoxazole, and with two exceptions, resistance to tilmicosin was also detected. Each strain was susceptible to ampicillin, streptomycin, gentamycin, tetracycline, doxycycline, cefazolin, cefpodoxime, chloramphenicol, florfenicol and enrofloxacin. Common characteristics (virulence profile and antibiotic sensitivity pattern) shared by strains isolated from humans and cats support the view that domestic cats may serve as a potential reservoir for P. multocida.

Effectiveness of intra-arterial steroid administration for the treatment of steroid-refractory acute gastrointestinal graft-versus-host disease.

AIM: To retrospectively assess the clinical effectiveness of intra-arterial steroid administration (IASA) treatment in adult patients who developed steroid-refractory gastrointestinal acute graft-versus-host disease (GI-aGvHD) (≥stage II) following haematopoietic stem cell transplantation. MATERIALS AND METHODS: Clinical data of 10 consecutive adult patients (age range, 19-61 years; mean age, 42 years) of a single centre with GI-aGvHD (≥stage II) who showed no response to intravenous methylprednisolone and received IASA into the superior (SMA) and/or inferior mesenteric arteries (IMA) were analysed. The severity of aGvHD was determined as the volume of diarrhoea (stages 0-IV) and the Glucksberg grading system before and 12±3 SD, 27±4 and 54±6 days after IASA treatment. Median follow-up was 65 days (range, 22-370 days). RESULTS: Six out of 10 patients at 12 days, 8/10 patients at 27 days, 6/10 patients at 54 days after IASA showed gastrointestinal response. Among them, 1/10 patients at 12 days, 4/10 patients at 27 days, and the same 4/10 patients at 54 days showed complete resolution of GI-aGvHD. The 4/10 patients who reached complete resolution of GI-aGvHD at day 12 or 27 showed a sustained symptom-free state. One in 10 patient showed only a temporary response, 5/10 patients died between days 22 and 67. CONCLUSIONS: IASA seems to be a potentially useful second-line therapy for intravenous steroid-refractory GI-aGvHD.

Prognostic value of pre-embolisation MRI features of uterine fibroids in uterine artery embolisation.

AIM: To evaluate the prognostic value of pretreatment pelvic magnetic resonance imaging (MRI) features in uterine artery embolisation (UAE) for symptomatic fibroids. MATERIALS AND METHODS: MRI characteristics of 109 fibroids (≥3 cm) in 70 patients were analysed retrospectively. Imaging was performed 1.8±1.3 (SD) months before and 6.6±1.8 months after UAE. On pretreatment images, signal intensity (SI) of fibroids was compared with that of the myometrium and skeletal muscle on T1- and T2-weighted sequences; the contrast enhancement pattern and localisation of fibroids were also analysed. Fibroid volume reduction (VR) was assessed by control imaging. The numerical analogue quality-of-life score was obtained before and after UAE. Statistical analysis was performed using the Mann-Whitney U-test, Kruskal-Wallis test, and Wilcoxon signed-rank test. RESULTS: The mean fibroid volume decreased by 51.1±30.8% during the 6.6±1.8 months (p<0.001). Mean quality-of-life score improved by 48.2±27.6 points (p<0.001). The mean VR of submucosal fibroids (82.1±18.5%) was greater than that of intramural (49.4±30.7%) and subserosal (43±28.3%) fibroids (p<0.001 for both). Fibroids that were isointense/hyperintense to myometrium on T2-weighted images showed a better response than hypointense fibroids (63.7±25.8% versus 48.6±31.3%, respectively; p=0.041). On contrast-enhanced images, isointense/hyperintense fibroids showed a better VR than hypointense fibroids (61.3±27.4% versus 47.6±31.6%, respectively; p=0.035). Baseline fibroid volume of <50 cm3 was also associated with favourable imaging outcome (p=0.021). T2 SI compared to skeletal muscle and T1 SI compared to myometrium or skeletal muscle did not show association with VR. CONCLUSIONS: Localisation, T2 SI, contrast enhancement, and <50 cm3 fibroid volume were associated with better VR; these may help with treatment decisions.

Interaction of Pure Marangoni Convection with a Propagating Reactive Interface under Microgravity.

A reactive interface in the form of an autocatalytic reaction front propagating in a bulk phase can generate a dynamic contact line upon reaching the free surface when a surface tension gradient builds up due to the change in chemical composition. Experiments in microgravity evidence the existence of a self-organized autonomous and localized coupling of a pure Marangoni flow along the surface with the reaction in the bulk. This dynamics results from the advancement of the contact line at the surface that acts as a moving source of the reaction, leading to the reorientation of the front propagation. Microgravity conditions allow one to isolate the transition regime during which the surface propagation is enhanced, whereas diffusion remains the main mode of transport in the bulk with negligible convective mixing, a regime typically concealed on Earth because of buoyancy-driven convection.

Photon dose at the maze entrance door: The comparison of flattening filter and flattening filter free working modes.

In recent years, field flattening free accelerators have been introduced in therapy practice. One of the objective of these measurements was to establish if the maze door, designed for accelerators operating with flattening filter can provide adequate shielding in field flattening free mode of operation. Linac installed in this standard one band maze vault is equipped to operate at 6 MV with field flattening filter and in field flattening free mode of operation. Series of measurements of the photon dose at the maze door (with different jaws openings and gantry positions) were performed in both operation modes with and without water canister to mimic standard therapy conditions. In this paper results of photon dose measurements, performed at the maze door of the therapy linear accelerator vault are presented in order to compare photon dose in flattening filter and flattening filter free operation modes. It was obtained that in field flattening free mode of operation, the dose at the maze door is always lower than the dose measured in standard mode of operation with the field flattening filter. In the case when FFF therapy practice should start in some existing therapy vault, no additional shielding measures need to be added at the existing maze door.

Peristalticity-driven banded chemical garden.

Complex structures in nature are often formed by self-assembly. In order to mimic the formation, to enhance the production, or to modify the structures, easy-to-use methods are sought to couple engineering and self-assembly. Chemical-garden-like precipitation reactions are frequently used to study such couplings because of the intrinsic chemical and hydrodynamic interplays. In this work, we present a simple method of applying periodic pressure fluctuations given by a peristaltic pump which can be used to achieve regularly banded precipitate membranes in the copper-phosphate system.

Effect of the intracellular calcium concentration chelator BAPTA acetoxy-methylester on action potential duration in canine ventricular myocytes.

Intracellular calcium concentration ([Ca2+]i) is often buffered by using the cell-permeant acetoxy-methylester form of the Ca2+ chelator BAPTA (BAPTA-AM) under experimental conditions. This study was designed to investigate the time-dependent actions of extracellularly applied BAPTA-AM on action potential duration (APD) in cardiac cells. Action potentials were recorded from enzymatically isolated canine ventricular myocytes with conventional sharp microelectrodes. The effect of BAPTA-AM on the rapid delayed rectifier K+ current (IKr) was studied using conventional voltage clamp and action potential voltage clamp techniques. APD was lengthened by 5 µM BAPTA-AM - but not by BAPTA - and shortened by the Ca2+ ionophore A23187 in a time-dependent manner. The APD-lengthening effect of BAPTA-AM was strongly suppressed in the presence of nisoldipine, and enhanced in the presence of BAY K8644, suggesting that a shift in the [Ca2+]i-dependent inactivation of L-type Ca2+ current may be an important underlying mechanism. However, in the presence of the IKr-blocker dofetilide or E-4031 APD was shortened rather than lengthened by BAPTA-AM. Similarly, the APD-lengthening effect of 100 nM dofetilide was halved by the pretreatment with BAPTA-AM. In line with these results, IKr was significantly reduced by extracellularly applied BAPTA-AM under both conventional voltage clamp and action potential voltage clamp conditions. This inhibition of IKr was partially reversible and was not related to the Ca2+ chelator effect BAPTA-AM. The possible mechanisms involved in the APD-modifying effects of BAPTA-AM are discussed. It is concluded that BAPTA-AM has to be applied carefully to control [Ca2+]i in whole cell systems because of its direct inhibitory action on IKr.

Functional genomics in the wild: a case study with paper wasps shows challenges and prospects for RNA interference in ecological systems.

RNA interference (RNAi) is a useful tool to assess gene function by knocking down expression of a target gene and has been used successfully in domestic and laboratory organisms. However, the use of RNAi for functional genomics has not fully extended into ecological model organisms in natural environments. Assessment of gene function in the wild is important because gene function can be environmentally and context dependent. Here, we present a case study using RNAi to assess gene function in wild paper wasps Polistes metricus, to test roles for two candidate genes (NADH dehydrogenase (NADHdh) and retinoid and fatty acid binding protein (RfaBp)) in the development of reproductive castes. Previous studies have shown that these genes are upregulated in larvae that become queens compared to workers, but this pattern was reversed in the laboratory, making field-based studies necessary. We orally administered dsRNA to larvae in field colonies and found evidence of a short-term knockdown followed by a compensatory rebound in expression for RfaBp. We also observed the predicted worker-like decrease in lipid stores in NADHdh dsRNA treated wasps, suggesting a possible role for NADHdh in caste development. We discuss our results in the context of challenges for using RNAi for functional genomics in ecological model organisms in the field.

Towards a situation-and-user-aware multi-modal motorized toilet system to assist older adults with disabilities: A user requirements study.

In the recent decades state of the art technologies appeared in many areas to assist older adults with disabilities. However, one very essential activity of daily life, the toileting remained without any relevant development. The iToilet project of the European Union focuses on the development of an intelligent and motorized toilet system to enable independent toilet use for older adults with disabilities. To begin the development, the user requirements of end-users were assessed by means of focus group interviews and questionnaires. The survey was conducted in Austria and Hungary with the participation of 74 persons in total (41 subjects with movement disorders, 21 caregivers and 12 healthcare managers). From the interviews, the ranking of functions and features based on the number of their mentions was derived. The raw ranking was modulated by the average ratings from the questionnaires that resulted in the final list of priorities. Our results suggest that a safe and intelligent motorized toilet system should have foldable handrails on both sides (especially for wheelchair users), motorized height and tilt adjusting mechanism for the toilet bowl, fixed toilet paper holder on both sides and emergency recognition with call function. Simple operation, storage and retrieval of user specific settings including bowl height, and user identification were also deemed as very important features, while the possibility to control functions with gestures was valued rather low.

Alteration of sarcoplasmic reticulum Ca2+ ATPase expression in lower limb ischemia caused by atherosclerosis obliterans.

Atherosclerosis is a disease caused by a build-up of fatty plaques and cholesterol in the arteries. The lumen of the vessels is obliterated resulting in restricted blood supply to tissues. In ischemic conditions, the cytosolic Ca2+ level of skeletal muscle may increase, indicating the alteration of Ca2+ removal mechanisms. Ca2+ is transported from cytosol into the sarcoplasmic reticulum by Ca2+ ATPase (SERCA), with its 1a isoform expressed in adult, while its 1b isoform in neonatal and regenerating fast-twitch skeletal muscle. To investigate the role of these isoforms in ischemic skeletal muscle, biopsies from musculus biceps femoris of patients who underwent amputation due to atherosclerosis were examined. Samples were removed from the visibly healthy and hypoxia-affected tissue. Significantly increased SERCA1a expression was detected under the ischemic conditions (246 ± 69%; p < 0.05) compared with the healthy tissue. Furthermore, the ratio of SERCA1a-positive fibers was slightly increased (46 ± 4% in healthy tissue and 60 ± 5% in ischemic tissue; p > 0.05), whereas SERCA2a did not change. In addition, in primary cultures derived from hypoxia-affected tissue, the diameter and fusion index of myotubes were significantly increased (30 ± 1.6 µm vs. 41 ± 2.4 µm and 31 ± 4% vs. 45 ± 3%; p < 0.05). We propose that the increased SERCA1a expression indicates the existence and location of compensating mechanisms in ischemic muscle.

The evaluation of the neutron dose equivalent in the two-bend maze.

The purpose of this study was to explore the effect of the second bend of the maze, on the neutron dose equivalent, in the 15MV linear accelerator vault, with two bend maze. These two bends of the maze were covered by 32 points where the neutron dose equivalent was measured. There is one available method for estimation of the neutron dose equivalent at the entrance door of the two bend maze which was tested using the results of the measurements. The results of this study show that the neutron equivalent dose at the door of the two bend maze was reduced almost three orders of magnitude. The measured TVD in the first bend (closer to the inner maze entrance) is about 5m. The measured TVD result is close to the TVD values usually used in the proposed models for estimation of neutron dose equivalent at the entrance door of the single bend maze. The results also determined that the TVD in the second bend (next to the maze entrance door) is significantly lower than the TVD values found in the first maze bend.

Toward the Full Quantum Dynamical Description of Photon Induced Processes in D2.

The dissociative ionization (multiphoton regime) of the D2+ ion by ultrashort laser pulses has been studied theoretically using ab initio calculations. The combined ionization and dissociation spectrum was explored for fixed molecular axis orientations. In accordance with previous investigations, the dominant features in the obtained joint energy spectrum were multiphoton peaks. In addition to this, in the present work, photoelectron angular distributions were analyzed as well. By performing a partial wave analysis for each multiphoton peak, we have identified the number of absorbed photons. Moreover, we also found that the angular distribution can significantly change inside a multiphoton peak as a function of electron and nuclear kinetic energy.

Acetylsalicylic Acid Resistance After Simultaneous Pancreas-Kidney Transplantation.

BACKGROUND: The most common conditions leading to death after simultaneous pancreas-kidney transplantations (SPKs) are cardiovascular diseases. The aim of this study was to test the platelet aggregation inhibitor acetylsalicylic acid (ASA) resistance in patients after SPKs, including investigations into the triggering factors. METHODS: Thirty-two patients (22 men, 10 women; overall age, 47.4 ± 8.6 years) were involved in our study and took 100 mg ASA per day. We used optical platelet aggregometry to detect resistance. RESULTS: Resistance occurred in 40.6% of the study group. However, with the use of logistic regression analysis, the examined 24 factors did not show any significant correspondence with resistance. CONCLUSIONS: The incidence of ASA resistance seems to be higher compared with other groups, but the triggering effect is still unproved. Clarifying this question should be important regarding the mortality- and morbidity-reducing capacity of antiplatelet drugs in the management of cardiovascular conditions.

Controlled reperfusion reduces hemorheological alterations in a porcine infrarenal aortic-clamping ischemia-reperfusion model.

INTRODUCTION: Restoration of blood flow after prolonged acute ischemia causes further injury to tissues. The role of increased oxidative stress is emphasized in the pathogenesis, and impairment of hemorheological factors may also hinder proper microcirculation. Controlled reperfusion at lowered pressure with diluted blood may help to decrease reperfusion injury. METHODS: Four-hour infrarenal aortic clamping was performed in 16 Yorkshire pigs. In 8 animals blood flow was restored subsequently (full reperfusion, FR), in the other 8 animals clamping was followed by an initial 30 minutes of controlled reperfusion (CR) at 60 mmHg pressure with a 1 : 1 ratio mixture of blood and reperfusion solution. Blood samples were taken before the intervention, at the end of ischemia, 15 minutes, 60 minutes, 1 day and 1 week after the start of reperfusion. Hemorheological parameters were measured. RESULTS: Hematocrit, plasma and whole blood viscosity decreased significantly during CR, these attenuated at 1 day. At 1 week whole blood and plasma viscosities were elevated in the FR group. Erythrocyte deformability did not change significantly at any measurements. Erythrocyte aggregation decreased during CR but not in FR, and was found elevated in both groups at 1 week. CONCLUSION: Our results suggest slightly improved hemorheological properties in case of controlled reperfusion compared to full reperfusion, which may help to reduce tissue damage.