Thermal Evaluation of Multi-Antenna Systems Proposed to Treat Bone Tumors: Finite Element Analysis.

Microwave ablation is commonly used in soft tissue tumors, but its application in bone tumors has been barely analyzed. Antennas to treat bone tissue (~3 cm2), has been lately designed. Bone tumors at pathological stage T1 can reach 8 cm wide. An antenna cannot cover it; therefore, our goal is to evaluate the thermal performance of multi-antenna arrays. Linear, triangular, and square configurations of double slot (DS) and monopole (MTM) antennas were evaluated. A parametric study (finite element method), with variations in distance between antennas (ad) and bone thickness (bt) was implemented. Array feasibility was evaluated by SWR, ablated tissue volume, etc. The linear configuration with DS and MTM antennas showed SWR ≤ 1.6 for ad = 1 mm−15 mm and bt = 20 mm−40 mm, and ad = 10 mm−15 mm and bt = 25 mm−40 mm, respectively; the triangular showed SWR ≤ 1.5 for ad = 5 mm−15 mm and bt = 20 mm−40 mm and ad = 10 mm−15 mm and bt = 25 mm−40 mm. The square configuration (DS) generated SWR ≤ 1.5 for ad = 5 mm−20 mm and bt = 20 mm−40 mm, and the MTM, SWR ≤ 1.5 with ad = 10 mm and bt = 25 mm−40 mm. Ablated tissue was 4.65 cm3−10.46 cm3 after 5 min. According to treatment time and array configuration, maximum temperature and ablated tissue is modified. Bone tumors >3 cm3 can be treated by these antenna-arrays.

Anatomical 3D Modeling Using IR Sensors and Radiometric Processing Based on Structure from Motion: Towards a Tool for the Diabetic Foot Diagnosis.

Medical infrared thermography has proven to be a complementary procedure to physiological disorders, such as the diabetic foot. However, the technique remains essentially based on 2D images that display partial anatomy. In this context, a 3D thermal model provides improved visualization and faster inspection. This paper presents a 3D reconstruction method associated with temperature information. The proposed solution is based on a Structure from Motion and Multi-view Stereo approach, exploiting a set of multimodal merged images. The infrared images were obtained by automatically processing the radiometric data to remove thermal interferences, segment the RoI, enhance false-color contrast, and for multimodal co-registration under a controlled environment and a ∆T < 2.6% between the RoI and thermal interferences. The geometric verification accuracy was 77% ± 2%. Moreover, a normalized error was adjusted per sample based on a linear model to compensate for the curvature emissivity (error ≈ 10% near to 90°). The 3D models were displayed with temperature information and interaction controls to observe any point of view. The temperature sidebar values were assigned with information retrieved only from the RoI. The results have proven the feasibility of the 3D multimodal construction to be used as a promising tool in the diagnosis of diabetic foot.

Bacterial Cellulose-Chitosan Paper with Antimicrobial and Antioxidant Activities.

The production of paper-based bacterial cellulose-chitosan (BC-Ch) nanocomposites was accomplished following two different approaches. In the first, BC paper sheets were produced and then immersed in an aqueous solution of chitosan (BC-ChI); in the second, BC pulp was impregnated with chitosan prior to the production of paper sheets (BC-ChM). BC-Ch nanocomposites were investigated in terms of physical characteristics, antimicrobial and antioxidant properties, and the ability to inhibit the formation of biofilms on their surface. The two types of BC-Ch nanocomposites maintained the hydrophobic character, the air barrier properties, and the high crystallinity of the BC paper. However, BC-ChI showed a surface with a denser fiber network and with smaller pores than those of BC-ChM. Only 5% of the chitosan leached from the BC-Ch nanocomposites after 96 h of incubation in an aqueous medium, indicating that it was well retained by the BC paper matrix. BC-Ch nanocomposites displayed antimicrobial activity, inhibiting growth of and having a killing effect against bacteria Staphylococcus aureus and Pseudomonas aeruginosa and yeast Candida albicans. Moreover, BC-Ch papers showed activity against the formation of a biofilm on their surface. The incorporation of chitosan increased the antioxidant activity of the BC paper. Paper-based BC-Ch nanocomposites combined the physical properties of BC paper and the antimicrobial, antibiofilm, and antioxidant activities of chitosan.

Prevalence of vertebral fracture and densitometric osteoporosis in Spanish adult men: The Camargo Cohort Study.

The aim of this study was to assess the prevalence of densitometric osteoporosis and vertebral fractures in Spanish men aged ≥50 years, and to study how the relationship between them may change depending on how osteoporosis is diagnosed. A community-based population of 1003 men aged ≥50 years was studied. Bone mineral density (BMD) was measured by DXA at the lumbar spine, femoral neck and total hip. Vertebral fractures were assessed by lateral thoracic and lumbar spine radiographs. The prevalence of osteoporosis was estimated with both the World Health Organization (WHO) (T-score of <-2.5 at the femoral neck, calculated using the young white female normal reference database) and the National Osteoporosis Foundation (NOF) criteria (T-score of <-2.5 at the femoral neck, total hip or lumbar spine, calculated using the young white male normal reference database). The prevalence of osteoporosis using the WHO criterion was 1.1% and using the NOF criterion was 13%, while that of vertebral fractures was 21.3%. The area under the curve (AUC) for the relationship between BMD and vertebral fracture prevalence was 0.64. The odds ratio for osteoporosis using the WHO definition was 2.57 (p = 0.13), and 1.78 (p = 0.007) using the NOF definition. Vertebral fracture prevalence rose with age. The prevalence of osteoporosis increased only moderately in men aged >70 years with the WHO criterion, and showed no change using the NOF definition. The prevalence of osteoporosis in Spanish men using the WHO definition is too small to have any meaningful clinical use. Although the figure is higher using the NOF definition, it would seem that population-based studies of BMD in men are of questionable value.

A Dependable Massive Storage Service for Medical Imaging.

We present the construction of Babel, a distributed storage system that meets stringent requirements on dependability, availability, and scalability. Together with Babel, we developed an application that uses our system to store medical images. Accordingly, we show the feasibility of our proposal to provide an alternative solution for massive scientific storage and describe the software architecture style that manages the DICOM images life cycle, utilizing Babel like a virtual local storage component for a picture archiving and communication system (PACS-Babel Interface). Furthermore, we describe the communication interface in the Unified Modeling Language (UML) and show how it can be extended to manage the hard work associated with data migration processes on PACS in case of updates or disaster recovery.

Gender Differences in Quantitative Electroencephalogram During a Simple Hand Movement Task in Young Adults.

BACKGROUND: No consensus has been reached regarding the existence of gender differences during motor tasks in electroencephalography. This could lead to misinterpretation of electroencephalography clinical diagnosis and affect the calibration of brain-computer interfaces. OBJECTIVE: To assess whether there are statistically significant gender differences in electroencephalography recorded during hand movements. METHODS: Electroencephalography data were recorded from 18 women and 18 men while performing hand movements and rest. Electroencephalography power was computed for alpha (8-13 Hz), beta (14-30 Hz), and a broader band including alpha and beta (8-30 Hz) using wavelet transform. Statistical analysis was done using a General Linear Model for repeated measurements (α = 0.05). Additionally, topographic maps were computed for each gender. RESULTS: Significant gender differences were found for the rest condition in all analyzed bands. For the hand movement tasks, gender differences were mainly found in the beta band and located in temporoparietal areas. Power decrease observed in topographic maps was located in the centro-parietal areas for females and the centro-frontal areas for males. Additionally, greater power decreases were observed for women in all analyzed frequency bands. CONCLUSION: Electroencephalography parameters used for the diagnosis of neuromotor diseases, as well as for brain-computer interface calibration, must take gender into account.

Business Model for the Security of a Large-Scale PACS, Compliance with ISO/27002:2013 Standard.

Data security is a critical issue in an organization; a proper information security management (ISM) is an ongoing process that seeks to build and maintain programs, policies, and controls for protecting information. A hospital is one of the most complex organizations, where patient information has not only legal and economic implications but, more importantly, an impact on the patient's health. Imaging studies include medical images, patient identification data, and proprietary information of the study; these data are contained in the storage device of a PACS. This system must preserve the confidentiality, integrity, and availability of patient information. There are techniques such as firewalls, encryption, and data encapsulation that contribute to the protection of information. In addition, the Digital Imaging and Communications in Medicine (DICOM) standard and the requirements of the Health Insurance Portability and Accountability Act (HIPAA) regulations are also used to protect the patient clinical data. However, these techniques are not systematically applied to the picture and archiving and communication system (PACS) in most cases and are not sufficient to ensure the integrity of the images and associated data during transmission. The ISO/IEC 27001:2013 standard has been developed to improve the ISM. Currently, health institutions lack effective ISM processes that enable reliable interorganizational activities. In this paper, we present a business model that accomplishes the controls of ISO/IEC 27002:2013 standard and criteria of security and privacy from DICOM and HIPAA to improve the ISM of a large-scale PACS. The methodology associated with the model can monitor the flow of data in a PACS, facilitating the detection of unauthorized access to images and other abnormal activities.

Bone mineral density in statin users: a population-based analysis from a Spanish cohort.

We studied 2,315 subjects (1,422 women and 893 men) from the Camargo Cohort and analyzed the differences in BMD between statin or non-statin users. We also studied effects of the type of statin, dose, pharmacokinetic properties, and length of treatment on bone mineral density (BMD). Of the subjects, 478 (21 %) were taking statins (256 women and 222 men). Overall, they had higher BMD than non-users (p < 0.0001). In adjusted multivariate models, women taking statins had higher BMD at femoral neck (p = 0.002) and total hip (p = 0.04) than non- users. No differences were found in men. Women taking simvastatin had higher increases in BMD than non-statin users at femoral neck (p = 0.02) and total hip (p = 0.009), those taking fluvastatin had lower BMD values at lumbar spine (p = 0.028), and those receiving lovastatin had higher increases at femoral neck (p = 0.006). In men, only atorvastatin was associated with higher femoral neck BMD than non-statin use (p = 0.029). Comparing with non-statin users, only women receiving lipophilic statins had greater BMD at femoral neck (p = 0.003). According to drug potency, women on high- or lower-potency agents showed higher BMD values at femoral neck than non-users (p = 0.028 and 0.022, respectively). In men, only high-potency statins were associated with higher femoral neck BMD than non-use (p = 0.021). No differences between dose or length of statin therapy were noted regarding BMD in either sex. In summary, in a large population-based cohort, women on statins had higher BMD at the hip than non-users. Overall, this increase in BMD was more evident in subjects on lipophilic or high-potency statins.

An approach to improve the performance of subject-independent BCIs-based on motor imagery allocating subjects by gender.

BACKGROUND: One of the difficulties for the implementation of Brain-Computer Interface (BCI) systems for motor impaired patients is the time consumed in the system design process, since patients do not have the adequate physical nor psychological conditions to complete the process. For this reason most of BCIs are designed in a subject-dependent approach using data of healthy subjects. The developing of subject-independent systems is an option to decrease the required training sessions to design a BCI with patient functionality. This paper presents a proof-of-concept study to evaluate subject-independent system based on hand motor imagery taking gender into account. METHODS: Subject-Independent BCIs are proposed using Common Spatial Patterns and log variance features of two groups of healthy subjects; one of the groups was composed by people of male gender and the other one by people of female gender. The performance of the developed gender-specific BCI designs was evaluated with respect to a subject-independent BCI designed without taking gender into account, and afterwards its performance was evaluated with data of two healthy subjects that were not included in the initial sample. As an additional test to probe the potential use for subcortical stroke patients we applied the methodology to two patients with right hand weakness. T-test was employed to determine the significance of the difference between traditional approach and the proposed gender-specific approach. RESULTS: For most of the tested conditions, the gender-specific BCIs have a statistically significant better performance than those that did not take gender into account. It was also observed that with a BCI designed with log-variance features in the alpha and beta band of healthy subjects' data, it was possible to classify hand motor imagery of subcortical stroke patients above the practical level of chance. CONCLUSIONS: A larger subjects' sample test may be necessary to improve the performances of the gender-specific BCIs and to further test this methodology on different patients. The reduction of complexity in the implementation of BCI systems could bring these systems closer to applications such as controlling devices for the motor rehabilitation of stroke patients, and therefore, contribute to a more effective neurological rehabilitation.

[Pilot study: Wrist digital sphygmomanometers as an alternative for noninvasive blood pressure measurement in pediatric population]. / Estudio piloto: los esfigmomanómetros digitales de muñeca como alternativa en la medición de la presión arterial no invasiva en población pediátrica.

In current clinical practice, the mercury sphygmomanometer (MS) is being replaced by alternatives as aneroid sphygmomanometer and semiautomatic and automatic-type digital sphygmomanometers (DS). However, a validated DS in adults may not be appropriate for use in the pediatric population, particularly for wrist-type devices. A pilot study was conducted to determine if wrist DS can replace the MS for clinical use in children population. Measuring blood pressure for pediatric patients with wrist diameter greater 13.5 cm was made. The correlation between wrist DS and mercurial device was evaluated and compared by Bland-Altman. The flexible-bracelet wrist DS (CH-656C) showed discrepancies in the mean ± standard deviation differences from 2.6 ± 5.5 to 5.8 ± 6.2 mmHg compared to the mercury device, while the rigid-wrist DS (CH-607) showed variations from 3.9 ± 5.2 to 11.4 ± 7.6 mmHg compared to the MS. For some cases, the agreement was not presented because the results are above the criteria of the American Association for Advancement Medical Instrumentation. This study revealed that the discrepancy of the results is so high for both digital devices, which makes it impossible suggest that any of them can replace the MS. Therefore, it is recommended that hospitals should ensure validation in the pediatric population before the wrist DS is used, particularly when it is utilized for diagnosis in children under 11 years.

[Technological advances in neurorehabilitation]. / Avances tecnológicos en neurorrehabilitación.

Neurological rehabilitation arose as formal method in the 60's, for the therapeutic treatment of patients with stroke or spinal cord injury, which develop severe sequelae that affect their motor and sensory abilities. Although the Central Nervous System has plasticity mechanisms for spontaneous recovery, a high percentage of patients should receive specialized therapies to regain motor function, such as Constraint Induced Movement Therapy or Upright physical Therapy. The neurorehabilitation has undergone drastic changes over the last two decades due to the incorporation of computer and robotic electronic devices, designed to produce positive changes in cortical excitability of the cerebral hemisphere damaged and so to improve neuroplasticity. Among equipment, we can mention those for electrotherapy devices, apparatus for transcranial magnetic stimulation, the robotic lower limb orthoses, robot for upper limb training, systems for functional electrical stimulation, neuroprosthesis and brain computer interfaces. These devices have caused controversy because of its application and benefits reported in the literature. The aim of Neurorehabilitation technologies is to take advantage of the functional neuromuscular structures preserved, and they compensate or re-learn the functions that previously made the damaged areas. The purpose of this article is to mention some clinical applications and benefits that these technologies offer to patients with neuronal injury.

[Characterization of electrical brain activity related to hand motor imagery in healthy subjects]. / Caracterización de la actividad eléctrica cerebral relacionada con la imaginacián del movimiento de la mano en sujetos sanos.

Brain computer interface systems (BCI) translate the intentions of patients affected with locked-in syndrome through the EEG signal characteristics, which are converted into commands used to control external devices. One of the strategies used, is to decode the motor imagery of the subject, which can modify the neuronal activity in the sensory-motor areas in a similar way to which it is observed in real movement. The present study shows the activation patterns that are registered in motor and motor imagery tasks of right and left hand movement in a sample of young healthy subjects of Mexican nationality. By means of frequency analysis it was possible to determine the difference conditions of motor imagery and movement. Using U Mann- Whitney tests, differences with statistical significance (p < 0.05) where obtained, in the EEG channels C3, Cz, C4, T3 and P3 in the mu and beta rhythms, for subjects with similar characteristics (age, gender, and education). With these results, it would be possible to define a classifier or decoder by gender that improves the performance rate and diminishes the training time, with the goal of designing a functional BCI system that can be transferred from the laboratory to the clinical application in patients with motor disabilities.

System to measure the range of motion of the joints of the human hand .

Today, the manual goniometer is a common tool used in clinical practice to measure the range of motion (ROM) of joints in the hand. This device is not only tedious and highly timeconsuming to use, but its accuracy mainly depends on the experience of the examiner. The majority of electronic goniometers currently available on the market exhibit these same limitations. This document presents the physical design and attributes of a system known as the MULTIELGON, which can be used automatically to obtain multiple measurements of the angles of the hand's small finger joints simultaneously using a novel angle-to-voltage transducer. The reproducibility and repeatability of the transducer were evaluated; low dispersion and high homogeneity were demonstrated. Correlation and Bland-Altman analyses were used to compare the accuracy of the novel transducer (A) and traditional manual goniometer (B); the correlation coefficient was 0.9995. The Bland-Altman analysis determined the limits of agreement (1.4° to 1.7°) with a 95% confidence interval for any variation between the instruments (A and B), which gave readings differing by less than 3.1°. Differences were sufficiently small to propose that the manual goniometer can be replaced by the transducer; moreover A is best to evaluate the hand's small finger joints than B. The system is comprised of the device, the interface and the MULTIELGON GUI. The device consists of 14 angle-to-voltage transducers that can be attached to joints in the hand using a PVC clamp and an elastic glove. The MULTIELGON can be utilized to evaluate patients, as well as record and manage ROM data for surgical and rehabilitation decisions.

Less underestimaton of excess weight by the categorical than the visual method. Its determinants and feeding practices in Mexican mothers of children aged 2 to 12 years.

Introduction: Introduction: perceived body weight refers to the subjectively assessed weight, which may not correspond to the objectively measured weight. Statistics show that 14 % to 83 % of parents misperceive their children's weight status, with a propensity for underestimation. Objective: we compared the accuracy of the visual versus the categorical method. We also identified factors and feeding practices associated with excess weight underestimation. Material and methods: we carried out a cross-sectional study in five states of Mexico with 1,845 mother-child dyads of children aged 2-12 years. The mothers were interviewed about weight perception with two methods, visual and categorical. The Child Feeding Questionnaire identified maternal feeding practices. Actual weight and height were categorized according to WHO criteria. Analysis consisted of Cohen's kappa estimation, multivariate logistic regression, and Mann-Whitney tests. Results: more mothers correctly identified the weight of their children with the categorical than with the visual method (68 % vs 42 %, p < 0.0001). The excess weight underestimation was lower (49 % vs 82 %, p < 0.0001) and the degree of agreement was higher with the categorical method (kappa, 0.39 and 0.08). The better results remained regardless of age. Age 2-5 years increased the odds of overweight/obesity underestimation. Feeding practices differed by weight perception category, child's age, and method of assessment. Conclusions: the categorical method was more accurate. Recognition of correct weight perception is one of the first actions required for controlling childhood overweight/obesity.

Introducción: Introducción: la percepción del peso corporal se refiere al peso evaluado subjetivamente, que puede no corresponder al peso medido objetivamente. Las estadísticas muestran que entre el 14 % y el 83 % de los padres tienen una percepción inadecuada del estado del peso de sus hijos, predominando la subestimación. Objetivo: comparar la precisión del método categórico y la del visual e identificar los factores y prácticas de alimentación asociados a la subestimación del exceso de peso. Material y métodos: se realizó un estudio transversal en cinco estados de México con 1,845 díadas madre-hijo de niños de 2-11 años. Las madres fueron entrevistadas sobre su percepción del peso con un método visual y uno categórico. El Cuestionario de Alimentación Infantil identificó las prácticas de alimentación. El peso y la altura se clasificaron con los criterios de la OMS. Se estimó la kappa de Cohen y se utilizaron la regresión logística multivariada y las pruebas de Mann-Whitney. Resultados: más madres identificaron correctamente el peso de sus hijos con el método categórico que con el visual (68 % vs. 42 %, p < 0,0001). La subestimación del exceso de peso fue menor (49 % vs 82 %, p <0,0001) y el grado de concordancia mayor con el método categórico (kappa: 0,39 y 0,08). Los resultados se mantuvieron independientemente de la edad. La edad de 2-5 años aumentó la probabilidad de subestimar el sobrepeso/obesidad. Las prácticas de alimentación difirieron por categoría de percepción del peso, edad del niño y método de evaluación. Conclusiones: el método categórico fue más preciso. El reconocimiento de la correcta percepción del peso constituye una de las primeras acciones para el control del sobrepeso/obesidad infantil.

Functional electrical stimulation therapy controlled by a P300-based brain-computer interface, as a therapeutic alternative for upper limb motor function recovery in chronic post-stroke patients. A non-randomized pilot study.

Introduction: Up to 80% of post-stroke patients present upper-limb motor impairment (ULMI), causing functional limitations in daily activities and loss of independence. UMLI is seldom fully recovered after stroke when using conventional therapeutic approaches. Functional Electrical Stimulation Therapy (FEST) controlled by Brain-Computer Interface (BCI) is an alternative that may induce neuroplastic changes, even in chronic post-stroke patients. The purpose of this work was to evaluate the effects of a P300-based BCI-controlled FEST intervention, for ULMI recovery of chronic post-stroke patients. Methods: A non-randomized pilot study was conducted, including 14 patients divided into 2 groups: BCI-FEST, and Conventional Therapy. Assessments of Upper limb functionality with Action Research Arm Test (ARAT), performance impairment with Fugl-Meyer assessment (FMA), Functional Independence Measure (FIM) and spasticity through Modified Ashworth Scale (MAS) were performed at baseline and after carrying out 20 therapy sessions, and the obtained scores compared using Chi square and Mann-Whitney U statistical tests (𝛼 = 0.05). Results: After training, we found statistically significant differences between groups for FMA (p = 0.012), ARAT (p < 0.001), and FIM (p = 0.025) scales. Discussion: It has been shown that FEST controlled by a P300-based BCI, may be more effective than conventional therapy to improve ULMI after stroke, regardless of chronicity. Conclusion: The results of the proposed BCI-FEST intervention are promising, even for the most chronic post-stroke patients often relegated from novel interventions, whose expected recovery with conventional therapy is very low. It is necessary to carry out a randomized controlled trial in the future with a larger sample of patients.

A software and hardware architecture for a high-availability PACS.

Increasing radiology studies has led to the emergence of new requirements for management medical information, mainly affecting the storage of digital images. Today, it is a necessary interaction between workflow management and legal rules that govern it, to allow an efficient control of medical technology and associated costs. Another important topic that is growing in importance within the healthcare sector is compliance, which includes the retention of studies, information security, and patient privacy. Previously, we conducted a series of extensive analysis and measurements of pre-existing operating conditions. These studies and projects have been described in other papers. The first phase: hardware and software installation and initial tests were completed in March 2006. The storage phase was built step by step until the PACS-INR was totally completed. Two important aspects were considered in the integration of components: (1) the reliability and performance of the system to transfer and display DICOM images, and (2) the availability of data backups for disaster recovery and downtime scenarios. This paper describes the high-availability model for a large-scale PACS to support the storage and retrieve of data using CAS and DAS technologies to provide an open storage platform. This solution offers a simple framework that integrates and automates the information at low cost and minimum risk. Likewise, the model allows an optimized use of the information infrastructure in the clinical environment. The tests of the model include massive data migration, openness, scalability, and standard compatibility to avoid locking data into a proprietary technology.

Control Violence Begins in Adolescent Dating: A Research from Students' Perception.

The purpose of this study was to analyze the prevalence of controlling violence experienced by adolescents in the Region of Murcia, as well as to analyze the patterns and sociodemographic variables involved such as sex, age, religious beliefs, sexual orientation, and country of origin of the families with the consequent cultural background provided. Using a sample of 454 secondary and high school students who completed a survey, the results revealed that 29.96% of the respondents were perpetrators (exerted violence) and 35.68% were victims of at least one dating abuse behavior. Significant differences were found in the occurrence of abuse based on family background, age, and religion. Finally, the results revealed that there were no significant differences in the victimization or perpetration of violence in relation to sex, but the older the victim, the less control exercised in cybernetic media, and the greater the control of the other in relation to family origin, where those from Latin American and African countries showed a greater propensity to control their partners than those of Spanish origin.

Devices and Technology in Transcranial Magnetic Stimulation: A Systematic Review.

The technology for transcranial magnetic stimulation (TMS) has significantly changed over the years, with important improvements in the signal generators, the coils, the positioning systems, and the software for modeling, optimization, and therapy planning. In this systematic literature review (SLR), the evolution of each component of TMS technology is presented and analyzed to assess the limitations to overcome. This SLR was carried out following the PRISMA 2020 statement. Published articles of TMS were searched for in four databases (Web of Science, PubMed, Scopus, IEEE). Conference papers and other reviews were excluded. Records were filtered using terms about TMS technology with a semi-automatic software; articles that did not present new technology developments were excluded manually. After this screening, 101 records were included, with 19 articles proposing new stimulator designs (18.8%), 46 presenting or adapting coils (45.5%), 18 proposing systems for coil placement (17.8%), and 43 implementing algorithms for coil optimization (42.6%). The articles were blindly classified by the authors to reduce the risk of bias. However, our results could have been influenced by our research interests, which would affect conclusions for applications in psychiatric and neurological diseases. Our analysis indicates that more emphasis should be placed on optimizing the current technology with a special focus on the experimental validation of models. With this review, we expect to establish the base for future TMS technological developments.

Personalized protocol and scoring scale for functional electrical stimulation of the hand: A pilot feasibility study.

BACKGROUND: Complex personalized Functional Electrical Stimulation (FES) protocols for calibrating parameters and electrode positioning have been proposed, most being time-consuming or technically cumbersome for clinical settings. Therefore, there is a need for new personalized FES protocols that generate comfortable, functional hand movements, while being feasible for clinical translation. OBJECTIVE: To develop a personalized FES protocol, comprising electrode placement and parameter selection, to generate hand opening (HO), power grasp (PW) and precision grip (PG) movements, and compare in a pilot feasibility study its performance to a non-personalized protocol based on standard FES guidelines. METHODS: Two FES protocols, one personalized (P1) and one non-personalized (P2), were used to produce hand movements in twenty-three healthy participants. FES-induced movements were assessed with a new scoring scale which comprises items for selectivity, functionality, and comfort. RESULTS: Higher FES-HSS scores were obtained with P1 for all movements: HO (p= 0.00013), PW (p= 0.00007), PG (p= 0.00460). Electrode placement time was significantly shorter for P2 (p= 0.00003). Comfort scores were similar for both protocols. CONCLUSIONS: The personalized protocol for electrode placement and parameter selection enabled functional FES-induced hand movements and presented advantages over a non-personalized protocol. This protocol warrants further investigation to confirm its suitability for developing upper-limb rehabilitation interventions with clinical translational potential.

The atherogenic index of plasma is related to a degraded bone microarchitecture assessed by the trabecular bone score in postmenopausal women: The Camargo Cohort Study.

OBJECTIVE: To assess the association between the atherogenic index of plasma (AIP) and the trabecular bone score (TBS) in postmenopausal women. Furthermore, to analyze its relationship with bone mineral density (BMD), and serum concentrations of 25OHD, PTH, and bone turnover markers. STUDY DESIGN: Cross-sectional study nested in a population-based cohort of 1,367 postmenopausal women aged 44-94 years. Participants were classified according to TBS values (<1.230, between 1.230-1.310 and >1.310) and regarding a widely accepted cut-off point of ≥0.11 for AIP. We analyzed TBS, BMD, serum levels of 25OHD, PTH, P1NP, CTX, and clinical covariates. A multivariate analysis was performed to assess the adjusted association between AIP and TBS. RESULTS: The mean age of participants was 63±10 years. Women with TBS values <1.230 were older, had greater BMI, greater prevalence of fractures after the age of 40 years, more years since menopause, higher values of AIP, and significantly lower levels of HDL-C, serum phosphate, and 25OHD. AIP values ≥0.11 were not associated with the presence of densitometric osteoporosis (OR=0.83, 95%CI 0.58-1.18; p = 0.30) but, in multivariate analysis, AIP values ≥0.11 were related to a degraded microarchitecture after controlling for age, BMI, smoking, diabetes status, ischemic heart disease, statin use, GFR, a fragility fracture at over 40 years of age and lumbar osteoporosis by DXA, with an adjusted OR=1.61 (95%CI 1.06-2.46; p = 0.009). CONCLUSIONS: AIP is significantly and independently associated with a degraded bone microarchitecture as measured by TBS. In this sense, AIP might be a useful tool in the overall assessment of bone metabolism in postmenopausal women.