A Comparison of Myoelectric Control Modes for an Assistive Robotic Virtual Platform.

In this paper, we propose a daily living situation where objects in a kitchen can be grasped and stored in specific containers using a virtual robot arm operated by different myoelectric control modes. The main goal of this study is to prove the feasibility of providing virtual environments controlled through surface electromyography that can be used for the future training of people using prosthetics or with upper limb motor impairments. We propose that simple control algorithms can be a more natural and robust way to interact with prostheses and assistive robotics in general than complex multipurpose machine learning approaches. Additionally, we discuss the advantages and disadvantages of adding intelligence to the setup to automatically assist grasping activities. The results show very good performance across all participants who share similar opinions regarding the execution of each of the proposed control modes.

A Deep Learning Approach to Estimate Multi-Level Mental Stress From EEG Using Serious Games.

Stress is revealed by the inability of individuals to cope with their environment, which is frequently evidenced by a failure to achieve their full potential in tasks or goals. This study aims to assess the feasibility of estimating the level of stress that the user is perceiving related to a specific task through an electroencephalograpic (EEG) system. This system is integrated with a Serious Game consisting of a multi-level stress driving tool, and Deep Learning (DL) neural networks are used for classification. The game involves controlling a vehicle to dodge obstacles, with the number of obstacles increasing based on complexity. Assuming that there is a direct correlation between the difficulty level of the game and the stress level of the user, a recurrent neural network (RNN) with a structure based on gated recurrent units (GRU) was used to classify the different levels of stress. The results show that the RNN model is able to predict stress levels above current state-of-the-art with up to 94% accuracy in some cases, suggesting that the use of EEG systems in combination with Serious Games and DL represents a promising technique in the prediction and classification of mental stress levels.

Crianças raras: vivências e desafios maternos / Children with rare diseases: maternal experiences and challenges

Objetivo: Analisar vivências e desafios de mães mediante a revelação do diagnóstico para anomalias congênitas. Métodos: Pesquisa qualitativa, exploratória e descritiva, desenvolvida no município de Dormentes, Estado de Pernambuco, Brasil, em Unidades Básicas de Saúde, através da entrevista semiestruturada, com 8 mães que receberam o diagnóstico para anomalia congênita durante o pré-natal ou pós-nascimento, ocorrida entre 2017 e 2022. Utilizou-se uma amostra não probabilística, por intencionalidade, com fechamento amostral por exaustão. Os dados coletados foram analisados a partir da técnica da análise temática de conteúdo. Resultados: As mães ao vivenciarem o diagnóstico experimentam medo, tristeza e luto. A revelação do diagnóstico implica em adaptações que envolvem toda a família, na qual, os desafios postos, ao receber a notícia, evidenciaram a importância do acolhimento, do esclarecimento do diagnóstico e apontaram para busca de informações e da religiosidade, como dispositivos de fortalecimento. Conclusão: Os achados desvelaram os processos adaptativos das famílias, principalmente das mães, apontando sobretudo para a necessidade de os profissionais, em específico, da enfermagem, repensarem seu papel alicerçado na empatia e na humanização, buscando o empoderamento das famílias para se adaptar ao novo, encorajando-as a vivenciarem o processo. Descritores: Anormalidades Congênitas; Relação Mãe-Filho; Enfermagem.

Objective: To analyze mothers' experiences and challenges when informed about a diagnosis of congenital anomalies.Methods:Qualitative, exploratory and descriptive research, developed at Basic Health Units in the municipality of Dormentes, state of Pernambuco, Brazil, through semi-structured interviews with 8 mothers who were informed about the diagnosis of a congenital anomaly during prenatal care or after birth, from 2017 to 2022. A non-probability and intentional sample was used, with closure due to exhaustion. The data collected were analyzed based on the thematic content analysis technique. Results: When informed about thediagnosis, the mothers experience fear, sadness and grief. Disclosure of the diagnosis implies adaptations that involve the entire family, in which the challenges posed upon receiving the news evidenced the importance of welcoming and of clarifying the diagnosis and pointed to the search for information and religiousness as strengthening devices.Conclusion:The findings revealed the families' adaptive processes, mainly in the mothers, pointing above all to the need for professionals, in particular, from the Nursing area, to rethink their role based on empathy and humanization, seeking to empower families to adapt to the new reality and encouraging them to experience the process. Descriptors: Congenital Abnormalities; Mother-Child Relations; Nursing.

Joint experimental and theoretical study of PbGa2S4 under compression.

The effect of pressure on the structural, vibrational, and optical properties of lead thiogallate, PbGa2S4, crystallizing under room conditions in the orthorhombic EuGa2S4-type structure (space group Fddd), is investigated. The results from X-ray diffraction, Raman scattering, and optical-absorption measurements at a high pressure beyond 20 GPa are reported and compared not only to ab initio calculations, but also to the related compounds α'-Ga2S3, CdGa2S4, and HgGa2S4. Evidence of a partially reversible pressure-induced decomposition of PbGa2S4 into a mixture of Pb6Ga10S21 and Ga2S3 above 15 GPa is reported. Thus, our measurements and calculations show a route for the high-pressure synthesis of Pb6Ga10S21, which is isostructural to the stable Pb6In10S21 compound at room pressure.

The 2-pyridone/2-hydroxypyridine tautomerism in gas phase: An excited state roaming reaction.

Multiconfigurational methods (CASSCF and CASPT2) were employed to gain a new understanding of the mechanism of the gas-phase phototautomerization of 2-pyridone/2-hydroxypyridine. Potential energy curves and crossing points of the low-lying excited states were analyzed. The results show that the tautomerization only occurs from 2-pyridone to 2-hydroxypyridine after electronic excitation to the S1 (ππ*) state. From this state, the system would be able to reach a conical intersection between S1 and the dissociative S2 (πσ*) due to vibrational effects. Then, it can evolve to the hydroxy form in its ground state by reaching an intersection seam between the S0 and the πσ* states. For this to happen, a roaming process responsible for the hydrogen atom migration would be required; otherwise, the system would revert to the 2-pyridone tautomer. The unfeasibility of the reverse process after optical excitation from the lactim to the lactam form is explained by the great amount of energy needed to reach the conical intersection between the ππ* and πσ* states. These findings would provide new insights into the understanding of the photophysics and photochemistry of a primordial heterocycle, considered a prebiotic model known to be found in interstellar clouds.

Multisensory Evaluation of Muscle Activity and Human Manipulability during Upper Limb Motor Tasks.

In this work, we evaluate the relationship between human manipulability indices obtained from motion sensing cameras and a variety of muscular factors extracted from surface electromyography (sEMG) signals from the upper limb during specific movements that include the shoulder, elbow and wrist joints. The results show specific links between upper limb movements and manipulability, revealing that extreme poses show less manipulability, i.e., when the arms are fully extended or fully flexed. However, there is not a clear correlation between the sEMG signals' average activity and manipulability factors, which suggests that muscular activity is, at least, only indirectly related to human pose singularities. A possible means to infer these correlations, if any, would be the use of advanced deep learning techniques. We also analyze a set of EMG metrics that give insights into how muscular effort is distributed during the exercises. This set of metrics could be used to obtain good indicators for the quantitative evaluation of sequences of movements according to the milestones of a rehabilitation therapy or to plan more ergonomic and bearable movement phases in a working task.

5-Year Collis-Nissen Gastroplasty Outcomes for Type III-IV Hiatal Hernia with Short Esophagus: A Prospective Observational Study.

BACKGROUND: To assess the 5-year outcomes of patients undergoing Collis-Nissen gastroplasty for type III-IV hiatal hernia with short esophagus. STUDY DESIGN: From a prospective observational cohort of patients who underwent antireflux surgery for type III-IV hiatal hernia between 2009 and 2020, those with short esophagus (abdominal length <2.5 cm) in whom a Collis-Nissen procedure was performed and reached at least 5 years of follow-up were identified. Hernia recurrence, patients' symptoms, and quality of life were assessed annually by barium meal x-ray, upper endoscopy, and validated symptoms and Quality of Life in Reflux and Dyspepsia (QOLRAD) questionnaires. RESULTS: Of the 114 patients with Collis-Nissen gastroplasty, 80 patients who completed a 5-year follow-up were included (mean age 71 years). There were no postoperative leaks or deaths. Recurrent hiatal hernia (any size) was identified in 7 patients (8.8%). Heartburn, regurgitation, chest pain, and cough were significantly improved at each follow-up interval (p < 0.05). Preoperative dysphagia disappeared or improved in 26 of 30 patients, while new-onset dysphagia occurred in 6. Mean postoperative QOLRAD scores significantly improved at all dimensions (p < 0.05). CONCLUSIONS: Collis gastroplasty combined with Nissen fundoplication provides low hernia recurrence, good control of symptoms, and improved quality of life in patients with large hiatal hernia and short esophagus.

Trans-cinnamaldehyde-related overproduction of benzoic acid and oxidative stress on Arabidopsis thaliana.

Introduction: Trans-cinnamaldehyde is a specialised metabolite that naturally occurs in plants of the Lauraceae family. This study focused on the phytotoxic effects of this compound on the morphology and metabolism of Arabidopsis thaliana seedlings. Material and methods: To evaluate the phytotoxicity of trans-cinnamaldehyde, a dose-response curve was first performed for the root growth process in order to calculate the reference inhibitory concentrations IC50 and IC80 (trans-cinnamaldehyde concentrations inducing a 50% and 80% inhibition, respectively). Subsequently, the structure and ultrastructure of the roots treated with the compound were analysed by light and electron microscopy. Based on these results, the following assays were carried out to in depth study the possible mode of action of the compound: antiauxinic PCIB reversion bioassay, determination of mitochondrial membrane potential, ROS detection, lipid peroxidation content, hormone quantification, in silico studies and gene expression of ALDH enzymes. Results: Trans-cinnamaldehyde IC50 and IC80 values were as low as 46 and 87 µM, reducing the root growth and inducing the occurrence of adventitious roots. At the ultrastructural level, the compound caused alterations to the mitochondria, which were confirmed by detection of the mitochondrial membrane potential. The morphology observed after the treatment (i.e., appearance of adventitious roots) suggested a possible hormonal mismatch at the auxin level, which was confirmed after PCIB bioassay and hormone quantification by GC-MS. The addition of the compound caused an increase in benzoic, salicylic and indoleacetic acid content, which was related to the increased gene expression of the aldehyde dehydrogenase enzymes that can drive the conversion of trans-cinnamaldehyde to cinnamic acid. Also, an increase of ROS was also observed in treated roots. The enzyme-compound interaction was shown to be stable over time by docking and molecular dynamics assays. Discussion: The aldehyde dehydrogenases could drive the conversion of trans-cinnamaldehyde to cinnamic acid, increasing the levels of benzoic, salicylic and indoleacetic acids and causing the oxidative stress symptoms observed in the treated seedlings. This would result into growth and development inhibition of the trans-cinnamaldehyde-treated seedlings and ultimately in their programmed-cell-death.

Melanoma Clinical Decision Support System: An Artificial Intelligence-Based Tool to Diagnose and Predict Disease Outcome in Early-Stage Melanoma Patients.

This study set out to assess the performance of an artificial intelligence (AI) algorithm based on clinical data and dermatoscopic imaging for the early diagnosis of melanoma, and its capacity to define the metastatic progression of melanoma through serological and histopathological biomarkers, enabling dermatologists to make more informed decisions about patient management. Integrated analysis of demographic data, images of the skin lesions, and serum and histopathological markers were analyzed in a group of 196 patients with melanoma. The interleukins (ILs) IL-4, IL-6, IL-10, and IL-17A as well as IFNγ (interferon), GM-CSF (granulocyte and macrophage colony-stimulating factor), TGFß (transforming growth factor), and the protein DCD (dermcidin) were quantified in the serum of melanoma patients at the time of diagnosis, and the expression of the RKIP, PIRIN, BCL2, BCL3, MITF, and ANXA5 proteins was detected by immunohistochemistry (IHC) in melanoma biopsies. An AI algorithm was used to improve the early diagnosis of melanoma and to predict the risk of metastasis and of disease-free survival. Two models were obtained to predict metastasis (including "all patients" or only patients "at early stages of melanoma"), and a series of attributes were seen to predict the progression of metastasis: Breslow thickness, infiltrating BCL-2 expressing lymphocytes, and IL-4 and IL-6 serum levels. Importantly, a decrease in serum GM-CSF seems to be a marker of poor prognosis in patients with early-stage melanomas.

Molecular Design of Interfaces of Model Food Nanoemulsions: A Combined Experimental and Theoretical Approach.

The composition and structure of the interfacial region of emulsions frequently determine its functionality and practical applications. In this work, we have integrated theory and experiments to enable a detailed description of the location and orientation of antioxidants in the interfacial region of olive-oil-in-water nanoemulsions (O/W) loaded with the model gallic acid (GA) antioxidant. For the purpose, we determined the distribution of GA in the intact emulsions by employing the well-developed pseudophase kinetic model, as well as their oxidative stability. We also determined, by employing an in silico design, the radial distribution functions of GA to gain insights on its insertion depth and on its orientation in the interfacial region. Both theoretical and experimental methods provide comparable and complementary results, indicating that most GA is located in the interfacial region (~81.2%) with a small fraction in the aqueous (~18.82%). Thus, GA is an effective antioxidant to inhibit lipid oxidation in emulsions not only because of the energy required for its reaction with peroxyl radical is much lower than that between the peroxyl radical and the unsaturated lipid but also because its effective concentration in the interfacial region is much higher than the stoichiometric concentration. The results demonstrate that the hybrid approach of experiments and simulations constitutes a complementary and useful pathway to design new, tailored, functionalized emulsions to minimize lipid oxidation.

Impacto de la COVID-19 en el área de Odontología

Introducción: La COVID-19 es una enfermedad provocada por el virus SARS-CoV-2, que se transmite por medio de la vía respiratoria por lo cual, los odontólogos enfrentan un gran riesgo al trabajar directamente en la cavidad oral. Objetivo: Sistematizar los referentes teóricos sobre el impacto de la COVID-19 en el área de la Odontología. Método: En la Universidad Regional Autónoma de los Andes, entre los meses de septiembre a diciembre de 2022 se realizó una revisión sistemática sobre el tema. De 36 artículos revisados se escogió, según criterios, un total de 23 artículos, disponibles en PUBMED y SciELO que abordan la problemática de COVID-19 en el área odontológica, de varios autores, en idioma inglés y español. Resultados: Se abordaron los temas, tales como: enfermedades bucodentales generadas a causa de COVID-19, Cambios en el área odontológica a causa de la pandemia por COVID-19 y medidas de bioseguridad empleadas para atender al paciente en el consultorio odontológico. Consideraciones finales: La COVID-19 ha tenido gran repercusión en Odontología, lo que afecta la salud bucal y general del paciente, a su vez, conduce al uso de estrictas medidas de bioseguridad dentro y fuera del consultorio odontológico, por lo que resulta ineludible que los odontólogos se empoderen de los referentes teóricos en torno al tema para contribuir a la detección de lesiones que puedan constituir signos primarios que apuntan a la presencia de SARS-CoV-2, adoptar conductas responsables y evitar su propagación.

Introduction: COVID-19 is a disease caused by SARS-CoV-2 virus and transmitted through respiratory track. So, dentists face a great risk working directly in the oral cavity. Objective: Systematization of the theoretical references concerning the impact of COVID-19 in dental areas. Method: A systematic review on the subject was carried out at the Universidad Regional Autónoma de los Andes, from September to December 2022. Of a total of 36 articles reviewed, 23 were selected according to criteria, available in PUBMED and SciELO, published in English and Spanish by different authors, and associated to the COVID-19 transmission in dentistry. Results: the following topics were addressed: oral diseases caused by COVID-19, changes in dental areas due to the COVID-19 pandemic, and biosecurity measures used in the dental service for ensure patient safety receiving treatment. Final considerations: COVID-19 has had great repercussions in dentistry, which affects the oral and general health of patients and, in turn, leads to the use of strict biosecurity measures inside and outside the dental office, so, it is essential for dentists to become empowered of the theoretical references related to the subject and also be focused on detecting lesions that may constitute primary signs of a possible presence of SARS-CoV-2, in adopt responsible behaviors and to avoid any spread of disease.

Introdução: O COVID-19 é uma doença causada pelo vírus SARS-CoV-2, que é transmitido pelo trato respiratório, portanto, os dentistas enfrentam um grande risco ao trabalhar diretamente na cavidade oral. Objetivo: Sistematizar os referenciais teóricos sobre o impacto da COVID-19 na área da Odontologia. Método: Na Universidade Regional Autônoma dos Andes, entre os meses de setembro e dezembro de 2022, foi realizada uma revisão sistemática sobre o tema. Dos 36 artigos revisados, um total de 23 artigos, disponíveis no PUBMED e SciELO, que abordam a problemática da COVID-19 na área odontológica, de diversos autores, em inglês e espanhol, foram escolhidos segundo critérios. Resultados: Foram abordados temas como: doenças bucais causadas pelo COVID-19, Alterações na área odontológica devido à pandemia do COVID-19 e medidas de biossegurança utilizadas no atendimento ao paciente no consultório odontológico. Considerações finais: O COVID-19 tem causado grande impacto na Odontologia, o que afeta a saúde bucal e geral do paciente, por sua vez, leva ao uso de medidas estritas de biossegurança dentro e fora do consultório odontológico, por isso é inevitável que os dentistas sejam capacitados por referenciais teóricos sobre o assunto para contribuir na detecção de lesões que possam constituir sinais primários que apontem para a presença do SARS-CoV-2, adotem condutas responsáveis e evitem sua disseminação.

ARMIA: A Sensorized Arm Wearable for Motor Rehabilitation.

In this paper, we present ARMIA: a sensorized arm wearable that includes a combination of inertial and sEMG sensors to interact with serious games in telerehabilitation setups. This device reduces the cost of robotic assistance technologies to be affordable for end-users at home and at rehabilitation centers. Hardware and acquisition software specifications are described together with potential applications of ARMIA in real-life rehabilitation scenarios. A detailed comparison with similar medical technologies is provided, with a specific focus on wearable devices and virtual and augmented reality approaches. The potential advantages of the proposed device are also described showing that ARMIA could provide similar, if not better, the effectivity of physical therapy as well as giving the possibility of home-based rehabilitation.

Percepções de educadoras ao Papanicolau entrelaçadas às questões de corpo / Perceptions of educators to the Papanicolau interlated to body issues / Percepciones de los educadores al Papanicolau interlados con temas corporales

Objetivo: apreender as percepções de educadoras sobre o Papanicolau associadas às questões de corpo. Método: qualitativo, exploratório e descritivo realizado com 18 educadoras de uma escola pública em Petrolina-PE, após aprovação pelo Comitê de Ética, parecer nº 4.048.369. Empregou-se o recurso gráfico, juntamente, à entrevista semi-estruturada, tratados pela análise semiológica de imagem e pela análise temática de conteúdo. Resultados: as educadoras conhecem a importância do exame, mas apresentaram superficialidade sobre o objetivo e materiais utilizados, além de sentimentos negativos como constrangimento, dor, desconforto, dentre outros. Logo, o profissional de saúde precisa considerar as especificidades femininas para a escolha do material, assim como, valorizar o que cada corpo pode sentir e falar, independente das queixas. Conclusão: assim, sob uma perspectiva reducionista percebe-se que um corpo que fala é silenciado pelas dimensões de descuido e não de cuidado em saúde

Objective: to apprehend the perceptions of educators about Pap smears associated with body issues. Method: qualitative, exploratory and descriptive carried out with 18 educators from a public school in Petrolina-PE, after approval by the Ethics Committee, opinion nº 4.048.369. The graphic resource was used, together with the semi-structured interview, treated by the semiological image analysis and the thematic content analysis. Results: the educators know the importance of the exam, but they were superficial about the purpose and materials used, in addition to negative feelings such as embarrassment, pain, discomfort, among others. Therefore, the health professional needs to consider women's specificities when choosing the material, as well as valuing what each body can feel and say, regardless of the complaints. Conclusion: thus, from a reductionist perspective, it is perceived that a speaking body is silenced by the dimensions of carelessness and not health care

Objetivo: comprender las percepciones de los educadores sobre las pruebas de Papanicolaou asociadas a problemas corporales. Método: cualitativo, exploratorio y descriptivo realizado con 18 educadores de un colegio público de Petrolina-PE, previa aprobación del Comité de Ética, dictamen nº 4.048.369. Se utilizó el recurso gráfico, junto con la entrevista semiestructurada, tratado por el análisis de imagen semiológico y el análisis de contenido temático. Resultados: los educadores conocen la importancia del examen, pero fueron superficiales sobre el propósito y los materiales utilizados, además de sentimientos negativos como vergüenza, dolor, malestar, entre otros. Por tanto, el profesional de la salud debe tener en cuenta las especificidades de las mujeres a la hora de elegir el material, así como valorar lo que cada cuerpo puede sentir y decir, independientemente de las quejas. Conclusión: así, desde una perspectiva reduccionista, se percibe que un cuerpo hablante es silenciado por las dimensiones del descuido y no del cuidado de la salud

A study on the impact of the users' characteristics on the performance of wearable fall detection systems.

Wearable Fall Detection Systems (FDSs) have gained much research interest during last decade. In this regard, Machine Learning (ML) classifiers have shown great efficiency in discriminating falls and conventional movements or Activities of Daily Living (ADLs) based on the analysis of the signals captured by transportable inertial sensors. Due to the intrinsic difficulties of training and testing this type of detectors in realistic scenarios and with their target audience (older adults), FDSs are normally benchmarked against a predefined set of ADLs and emulated falls executed by volunteers in a controlled environment. In most studies, however, samples from the same experimental subjects are used to both train and evaluate the FDSs. In this work, we investigate the performance of ML-based FDS systems when the test subjects have physical characteristics (weight, height, body mass index, age, gender) different from those of the users considered for the test phase. The results seem to point out that certain divergences (weight, height) of the users of both subsets (training ad test) may hamper the effectiveness of the classifiers (a reduction of up 20% in sensitivity and of up to 5% in specificity is reported). However, it is shown that the typology of the activities included in these subgroups has much greater relevance for the discrimination capability of the classifiers (with specificity losses of up to 95% if the activity types for training and testing strongly diverge).

Effect of ß-Blocker Withdrawal on Functional Capacity in Heart Failure and Preserved Ejection Fraction.

BACKGROUND: Chronotropic incompetence has shown to be associated with a decrease in exercise capacity in heart failure with preserved ejection fraction (HFpEF), yet ß-blockers are commonly used in HFpEF despite the lack of robust evidence. OBJECTIVES: This study aimed to evaluate the effect of ß-blocker withdrawal on peak oxygen consumption (peak Vo2) in patients with HFpEF and chronotropic incompetence. METHODS: This is a multicenter, randomized, investigator-blinded, crossover clinical trial consisting of 2 treatment periods of 2 weeks separated by a washout period of 2 weeks. Patients with stable HFpEF, New York Heart Association functional classes II and III, previous treatment with ß-blockers, and chronotropic incompetence were first randomized to withdrawing from (arm A: n = 26) versus continuing (arm B: n = 26) ß-blocker treatment and were then crossed over to receive the opposite intervention. Changes in peak Vo2 and percentage of predicted peak Vo2 (peak Vo2%) measured at the end of the trial were the primary outcome measures. To account for the paired-data nature of this crossover trial, linear mixed regression analysis was used. RESULTS: The mean age was 72.6 ± 13.1 years, and most of the patients were women (59.6%) in New York Heart Association functional class II (66.7%). The mean peakVo2 and peak Vo2% were 12.4 ± 2.9 mL/kg/min, and 72.4 ± 17.8%, respectively. No significant baseline differences were found across treatment arms. Peak Vo2 and peak Vo2% increased significantly after ß-blocker withdrawal (14.3 vs 12.2 mL/kg/min [Δ +2.1 mL/kg/min]; P < 0.001 and 81.1 vs 69.4% [Δ +11.7%]; P < 0.001, respectively). CONCLUSIONS: ß-blocker withdrawal improved maximal functional capacity in patients with HFpEF and chronotropic incompetence. ß-blocker use in HFpEF deserves profound re-evaluation. (ß-blockers Withdrawal in Patients With HFpEF and Chronotropic Incompetence: Effect on Functional Capacity [PRESERVE-HR]; NCT03871803; 2017-005077-39).

Bariatric surgery improves metabolic and nonalcoholic fatty liver disease markers in metabolically healthy patients with morbid obesity at 5 years.

BACKGROUND: No studies have evaluated the effect of metabolic and bariatric surgery (MBS) on nonalcoholic fatty liver disease (NAFLD) and cardiometabolic markers in metabolically healthy patients with morbid obesity (MHMO) at midterm. OBJECTIVES: To assess the effect of MBS on NAFLD and cardiometabolic markers in MHMO patients and ascertain whether metabolically unhealthy patients with morbid obesity (MUMO) remain metabolically healthy at 5 years after MBS. SETTING: University hospital. METHODS: A total of 191 patients with a body mass index >40 kg/m2 and at least 5 years of follow-up were retrospectively analyzed. Lost to follow-up were 37.6% (151 of 401 patients). Patients were classified as MHMO if 1 or 0 of the cardiometabolic markers were present using the Wildman criteria. The degree of liver fibrosis was assessed using the NAFLD fibrosis score (NFS). RESULTS: Forty-one patients (21.5%) fulfilled the criteria for MHMO. They showed significant improvements in blood pressure (from 135.1 ± 22.1 and 84.2 ± 14.3 mm Hg to 117.7 ± 19.2 and 73.0 ± 10.9 mm Hg), plasma glucose (from 91.0 ± 5.6 mg/dL to 87.2 ± 5.2 mg/dL), homeostatic model assessment for insulin resistance (from 2.2 ± .9 to 1.0 ± .8), triglycerides (from 88.0 [range, 79.5-103.5] mg/dL to 61.0 [range, 2.0-76.5] mg/dL), alanine aminotransferase, gamma-glutamyl transpeptidase NFS (from -1.0 ± 1.0 to -1.9 ± 1.2), and high-density lipoprotein cholesterol (from 56.9 ± 10.5 mg/dL to 77.9 ± 17.4 mg/dL) at 5 years after surgery. A total of 108 MUMO patients (84.4%) who became metabolically healthy after 1 year stayed healthy at 5 years. CONCLUSIONS: MBS induced a midterm improvement in cardiometabolic and NAFLD markers in MHMO patients. Seventy-six percent of MUMO patients became metabolically healthy at 5 years after MBS.

A Highly Efficient Neutral Anion Receptor in Polar Environments by Synergy of Anion-π Interactions and Hydrogen Bonding.

Herein, it is shown how anion recognition in highly polar solvents by neutral metal-free receptors is feasible when multiple hydrogen bonding and anion-π interactions are suitably combined. A neutral aromatic molecular tweezer functionalized with azo groups is shown to merge these two kinds of interactions in a unique system and its efficiency as an anion catcher in water is evaluated using first-principles quantum methods. Theoretical calculations unequivocally prove the high thermodynamic stability in water of a model anion, bromide, captured within the tweezer's cavity. Thus, static calculations indicate anion-tweezer interaction energies within the range of covalent or ionic bonds and stability constants in water of more than 10 orders of magnitude. First-principles molecular dynamics calculations also corroborate the stability through the time of the anion-tweezer complex in water. It shows that the anion is always found within the tweezer's cavity due to the combination of the tweezer-anion interactions plus a hydrogen bond between the anion and a water molecule that is inside the tweezer's cavity.

A Study of One-Class Classification Algorithms for Wearable Fall Sensors.

In recent years, the popularity of wearable devices has fostered the investigation of automatic fall detection systems based on the analysis of the signals captured by transportable inertial sensors. Due to the complexity and variety of human movements, the detection algorithms that offer the best performance when discriminating falls from conventional Activities of Daily Living (ADLs) are those built on machine learning and deep learning mechanisms. In this regard, supervised machine learning binary classification methods have been massively employed by the related literature. However, the learning phase of these algorithms requires mobility patterns caused by falls, which are very difficult to obtain in realistic application scenarios. An interesting alternative is offered by One-Class Classifiers (OCCs), which can be exclusively trained and configured with movement traces of a single type (ADLs). In this paper, a systematic study of the performance of various typical OCCs (for diverse sets of input features and hyperparameters) is performed when applied to nine public repositories of falls and ADLs. The results show the potentials of these classifiers, which are capable of achieving performance metrics very similar to those of supervised algorithms (with values for the specificity and the sensitivity higher than 95%). However, the study warns of the need to have a wide variety of types of ADLs when training OCCs, since activities with a high degree of mobility can significantly increase the frequency of false alarms (ADLs identified as falls) if not considered in the data subsets used for training.