Predicting orthophosphate in feces and manure from dairy cattle.

Dairy cattle excreta are a valuable source of orthophosphate (Ortho-P), an inorganic form of phosphorus (P) that is readily available for microorganisms, plant growth, and development. There is, however, a growing environmental concern about the potential negative environmental impact of excessive amounts of Ortho-P excretion, which can lead to the eutrophication of water bodies. As a result, the development of mathematical equations to quantify and manage Ortho-P excretion on dairy farms could prove valuable for environmental sustainability. This study aimed to use literature data to develop empirical predictions for Ortho-P (g/kg dry matter [DM]) excretion using total P (TP [g/kg DM]) content of dairy cattle feces (Ortho-Pf) and manure (Ortho-Pm). Data sets from studies that evaluated and characterized the different forms of P in feces and manure from dairy cattle were compiled. After outlier exclusion, the final retained database for feces included 37 treatment means from 4 published papers while the manure comprised 23 treatment means from 7 published papers. A linear-mixed model was used to develop the predictive equations, incorporating the random effect of the study. A leave-one-out cross-validation procedure was used to evaluate the predictive ability of the developed models, whereby studies were regarded as folds. The fecal equation was determined as Ortho-Pf (g/kg DM) = -2.447 (0.572) + 0.966 (0.083) × TP (g/kg DM) (R2 = 0.79) and resulted in a root mean square prediction error as a percentage of mean observed value (RMSPE, %) of 32.8% and error due to random sources of 97.6%. Additionally, the manure equation was determined as Ortho-Pm (g/kg) = -0.204 (0.446) + 0.590 (0.065) × TP (g/kg) (R2 = 0.77) and had an RMSPE of 43.3% with a random error of 93.9%. Both models revealed minimal mean and slope biases on feces and manure data. Findings suggest that these sets of equations can be used to estimate excreted Ortho-P from total excreted P, helping nutritionists and farmers to understand the impact of dietary P changes on the environment. Further, these equations can be incorporated into extant models such as the Cornell Net Carbohydrate and Protein System (CNCPS) to aid in understanding and mitigating P and Ortho-P excretion from dairy cattle and to clarify the portion of P that migrates more rapidly into watersheds.

Development and Validation of a Method for Hydrolysis and Analysis of Amino Acids in Ruminant Feeds, Tissue, and Milk Using Isotope Dilution Z-HILIC Coupled with Electrospray Ionization Triple Quadrupole LC-MS/MS.

Current analytical methods for amino acid (AA) analysis in ruminant nutrition are time-consuming and expensive. This study aimed to develop a method for AA analysis that is faster, more efficient, rugged, and accessible. Four representative matrixes were selected for method development and validation: milk, tissue, feed, and soy flour standard reference material from National Institute of Standards and Technology. Acid and alkaline hydrolysis were used to analyze 18 AA. Separation of AA was performed using a Z-HILIC column in an 18-min run coupled to a triple quadrupole LC/MS system in positive and negative electrospray ionization for identification and quantitation. The method was evaluated for recovery, precision, calibration curve linearity, and limits of detection (LODs) and limits of quantitation (LOQs) and applied to other feed samples. Good quantitation results were achieved for all AA, with coefficients of determination (R2) over 0.995; LODs at 0.2-28.2 and LOQs at 0.7-94.1 ng/mL; intraday and interday precision <14.9% relative standard deviation; blank recovery between 75.6 and 116.2%; and sample recovery between 75.6 and 118.0%. Overall, AA concentrations were similar to literature values, and there was a tendency for higher N recovery as AA. In conclusion, an efficient and robust method was validated to routinely analyze AA for appropriate characterization in diet formulation for dairy cattle.

Remote Voice Therapy With an Oscillatory Positive Expiratory Pressure Device in Subjects With Vocal Fatigue: A Randomized Controlled Trial.

PURPOSE: The present study aimed at assessing the efficacy of remote voice therapy (telepractice) implemented with Shaker Medic Plus device in subjects with vocal fatigue. METHOD: Thirty-six participants were initially enrolled in this study. Twenty-four participants with vocal fatigue were finally randomly assigned to one of two treatment groups: (a) voice treatment with Shaker Medic Plus device plus vocal hygiene program (n = 12) and (b) voice treatment with water resistance therapy (WRT) plus vocal hygiene program (n = 12). Laryngoscopic assessment was conducted on all subjects. Before and after voice therapy, participants underwent (a) self-assessment of voice: Vocal Fatigue Index and Vocal Tract Discomfort Scale and (b) instrumental assessment with aerodynamic, acoustic, and electroglottographic measures. The treatment period included six voice therapy sessions within 6 weeks. Each session lasted 30 min. For both groups, exercises consisted of a sequence of nine phonatory tasks performed with Shaker Medic Plus (experimental group) and WRT (control group). Comparisons for all variables were performed between the experimental group and control group. RESULTS: Significant improvements were found for self-reported variables when comparing pre- and postmeasures for both groups. No significant differences were found when comparing groups. No significant main effects or interactions were observed for any of the observed instrumental variables. CONCLUSIONS: Remote physiologic voice therapy with Shaker Medic Plus device and water resistance therapy seem to be both effective to improve voice in subjects diagnosed with vocal fatigue. No differences should be expected between these therapeutic protocols when treating patients with vocal fatigue. Moreover, both are effective at reducing tiredness of voice, voice avoidance, physical discomfort associated with voicing, subjective perception of sensory discomfort in throat, and reduction of physical, emotional, and functional impact of voice problems.

Efficacy of Voice Therapy With Acapella Choice ® Device in Subjects With Vocal Fatigue Delivered Via Telepractice.

PURPOSE: The present study aimed at assessing the effectiveness of remote voice therapy (telepractice) implemented with Acapella Choice device in subjects with vocal fatigue. METHODS: Thirty participants with vocal fatigue were randomly assigned to one of two treatment groups: (1) voice treatment with acapella Choice device plus vocal hygiene program (n=15), and (2) voice treatment with Water resistance therapy plus vocal hygiene program (n=15). Laryngoscopic assessment was conducted in all subjects to confirm diagnosis. Before and after voice therapy, participants underwent self-assessment of voice. Vocal Fatigue Index (VFI), Voice Handicap Index (VHI), and Vocal tract discomfort scale (VTDS) were used. Treatment period included six voice therapy sessions within 3 weeks, with a frequency of two therapy sessions per week. Each session lasted 30 minutes. For both groups, exercises consisted of a sequence of nine phonatory tasks performed with Acapella Choice (experimental group) and WRT (control group). Comparison for all variables were performed between experimental group and control group. RESULTS: Significant improvements were found when comparing Pre and Post measures for both groups. No significant differences were found when comparing Acapella Choice group and WRT group. CONCLUSION: Remote physiologic voice therapy with Acapella Choice device and water resistance therapy seem to be both effective to improve voice in subjects diagnosed with vocal fatigue. No differences should be expected between these therapeutic protocols when treating patients with vocal fatigue. Moreover, both are effective at reducing tiredness of voice, voice avoidance, physical discomfort associated with voicing, subjective perception of sensory discomfort in throat, and reduction of physical, emotional, and functional impact of voice problems.

Biomechanics of the Upper Limbs: A Review in the Sports Combat Ambit Highlighting Wearable Sensors.

Over time, inertial sensors have become an essential ally in the biomechanical field for current researchers. Their miniaturization coupled with their ever-improvement make them ideal for certain applications such as wireless monitoring or measurement of biomechanical variables. Therefore, in this article, a compendium of their use is presented to obtain biomechanical variables such as velocity, acceleration, and power, with a focus on combat sports such as included box, karate, and Taekwondo, among others. A thorough search has been made through a couple of databases, including MDPI, Elsevier, IEEE Publisher, and Taylor & Francis, to highlight some. Research data not older than 20 years have been collected, tabulated, and classified for interpretation. Finally, this work provides a broad view of the use of wearable devices and demonstrates the importance of using inertial sensors to obtain and complement biomechanical measurements on the upper extremities of the human body.

QoS-Aware Resource Allocation with Pilot-Aided Channel Estimation for Heterogeneous Wireless Networks.

The deployment of heterogeneous networks (HetNets) is a way to increase the network capacity and release part of the traffic generated by users inside a cell to small-scale wireless networks for service. In this context, the main problem is managing the interference due to the coexistence of small cells and macro cells. In this paper, a QoS-aware Resource Allocation (RA) algorithm jointly working with admission control (AC) over a two-tier HetNet scenario is investigated in the presence of both the pilot-symbols for channel estimation and the channel estimation error. The RA algorithm allows two users, the macro cell user (CU) and small cell user (SU), to simultaneously share the same resource block. Moreover, system performance and fairness are improved by including adaptive power allocation to users over resource blocks. In the framework of RA with proportional rate constraints, a novel algorithm is designed by including the effects of pilot-aided channel estimation. The algorithm is able to distribute the same proportional rate to all CUs and SUs, even in the presence of channel estimation error. Relevant numerical results for the downlink of a two-tier HetNet with pilot-aided channel estimation show that the rate dispersion is driven to zero while the sum-rate is maximized, and the average user rate penalty with respect to a perfect-CSI scenario may rise to 20%.

First-line haploidentical stem cell transplantation in children and adolescents with severe aplastic anemia using mobilized peripheral blood as source of CD34+: Single-institutional experience in a transplant center from northeast Mexico.

INTRODUCTION: The only curative treatment for severe aplastic anemia in children is an allogeneic stem cell transplant; however, few patients have a matched related or unrelated donor. Haploidentical stem cell transplantation (haplo-SCT) using bone marrow (BM) and peripheral blood stem cells (PBSC) has been recently described as effective and safe. In this study, we retrospectively report the outcome of twelve pediatric patients who underwent haplo-SCT using only PBSC. METHODS: The conditioning regimen consisted on rabbit anti-thymocyte globulin (r-ATG) 2.5 mg/kg/d on days -7, -6,-5, and -4, and cyclophosphamide (Cy) 50 mg/kg/d on days -3 and -2. We used Cy 50 mg/kg/d on days +3 and +4, tacrolimus and mycophenolic acid as graft versus host disease (GVHD) prophylaxis. RESULTS: The median follow-up was 1,099 days (45-1258 days). The overall survival rate up-to-date is 83.3%. In 10 of the 12 patients, a sustained graft was achieved. None of the patients had acute or chronic GVHD. CONCLUSIONS: Haplo-SCT could be established as a first-line treatment when there is no matched related or unrelated donor. According to this short sample and previous reports, PBSC are a feasible option effectively used as the sole source of stem cells. Additionally, post-transplant cyclophosphamide remains a good strategy for GVHD prevention.

Novel Approach Sizing and Routing of Wireless Sensor Networks for Applications in Smart Cities.

Citizens are expected to require the growth of multiple Internet of Things (IoT) -based applications to improve public and private services. According to their concept, smart cities seek to improve the efficiency, reliability, and resilience of these services. Consequently, this paper searches for a new vision for resolving problems related to the quick deployment of a wireless sensor network (WSN) by using a sizing model and considering the capacity and coverage of the concentrators. Additionally, three different routing models of these technology resources are presented as alternatives for each WSN deployment to ensure connectivity between smart meters and hubs required for smart metering. On the other hand, these solutions must reduce costs when this type of wireless communication network is deployed. The present work proposes various optimization models that consider the physical and network layers in order to integrate different wireless communication technologies, thus reducing costs in terms of the minimum number of data aggregation points. Using a heterogeneous wireless network can reduce resource costs and energy consumption in comparison to a single cellular technology, as proposed in previous works. This work proposes a sizing model and three different models for routing wireless networks. In each case, constraints are evaluated and can be associated with different real-world scenarios. This document provides an optimization model that encompasses all of the proposed constraints; due to the combinatorial nature of the problem, this would require a heuristic technique.

Clinical outcomes after 4.5 years of eliglustat therapy for Gaucher disease type 1: Phase 3 ENGAGE trial final results.

Eliglustat, an oral substrate reduction therapy, is approved for eligible adults with Gaucher disease type 1. In the Phase 3 ENGAGE trial of previously untreated adults with Gaucher disease type 1, eliglustat-treated patients had statistically significant improvements in organ volumes and hematologic parameters compared with placebo in the 9-month primary analysis. We report final outcomes by time on eliglustat among all patients who participated in the ENGAGE trial and extension. No patient deteriorated clinically or withdrew due to adverse events; 39/40 patients entered the open-label extension period and 34/40 (85%) remained in the trial until completion or switching to commercial eliglustat after its approval (2.3-6 years). Clinically meaningful improvements in Gaucher disease manifestations were seen in all patients concomitant with reductions in pathological lipid substrate levels (glucosylceramide and glucosylsphingosine). Among patients with 4.5 years of eliglustat exposure, mean spleen volume decreased by 66% (from 17.1 to 5.8 multiples of normal [MN], n = 13), mean liver volume decreased by 23% (from 1.5 to 1.1 MN, n = 13), mean hemoglobin increased 1.4 g/dl (from 11.9 to 13.4 g/dl, n = 12), mean platelet count increased by 87% (from 67.6 to 122.6 × 109 /L, n = 12), median chitotriosidase decreased by 82% (from 13 394 to 2312 nmol/h/ml, n = 11), median glucosylceramide decreased by 79% (from 11.5 to 2.4 µg/ml, n = 11), median glucosylsphingosine decreased by 84% (from 518.5 to 72.1 ng/ml, n = 10), and mean spine T-score increased from -1.07 (osteopenia) to -0.53 (normal) (n = 9). The magnitude of improvement in Gaucher disease manifestations and biomarkers over time was similar among the full trial cohort. Eliglustat was well-tolerated and led to clinically significant improvements in previously untreated patients with Gaucher disease type 1 during 4.5 years of treatment.

Agreement between body composition techniques in children and adolescents: narrative review of the literature. / Concordancia entre técnicas de composición corporal en niños y adolescentes: revisión narrativa de la literatura

Body composition monitoring is important to understand the effect of diet, physical activity, illness and growth on body stores. Body composition determination by accuracy and reproducibility techniques is essential. The objective of this study was to analyze the agreement between body composition techniques in children and adolescents. Literature search was performed using the PubMed, Scielo and Google Scholar databases. Only observational studies realized in children and adolescents that analyze agreement between two or more body composition techniques were included. Thirty studies were included. Dual-energy X-ray absorptiometry, air displacement plethysmography, hydrodensitometry, deuterium dilution and four compartment model were the techniques for body composition measurement and bioelectrical impedance and anthropometry were used to estimate body composition. Agreement and correlation between methods was influenced by study populations and by technique considered as gold standard for comparisons. In conclusion, there is a low agreement between the different methods to assess body composition. Correlation and agreement interpretation are essential for body composition assessment in children and adolescents. Is recommended the use of equations developed and validated in this populations.

El monitoreo de la composición corporal (CC) permite comprender los efectos de la dieta, el ejercicio físico, la presencia de procesos patológicos y el crecimiento en las reservas corporales; de ahí la importancia de su determinación con técnicas exactas y reproducibles. El objetivo de la presente revisión es analizar la concordancia entre las distintas técnicas para evaluar la CC en población infantil y adolescente. Se realizó una búsqueda no sistemática de la literatura en las bases de datos PubMed, Scielo y Google Scholar para identificar estudios cuyo objetivo primario fuera la evaluación de la concordancia entre dos o más métodos de determinación de la CC. Se incluyeron 30 estudios para la revisión. Los métodos identificados para la medición de la CC fueron la absorciometría dual de rayos X, la pletismografía de gases (BOD-POD), la hidrodensitometría, la dilución de deuterio (D2O) y el modelo de cuatro compartimentos, utilizando bioimpedancia eléctrica y antropometría para la estimación. La concordancia y la correlación entre métodos varía según los diferentes grupos poblacionales y la técnica utilizada como método de referencia. Se concluye que existe una baja concordancia entre los distintos métodos para evaluar la composición corporal. La interpretación de la correlación y la concordancia de los diferentes métodos resulta esencial para evaluar la CC en niños y adolescentes. Se sugiere utilizar ecuaciones desarrolladas o validadas para el grupo en estudio.

[Nurse prescription: A concept analysis]. / Prescripción enfermera: análisis de concepto.

OBJECTIVE: To critically analyse the concept of nursing prescription through the study of its background and a review of the scientific literature, in order to develop an accurate conception of this nursing activity and to identify the essential elements surrounding this concept. METHOD: Application of the concept analysis method described by Wilson, and adapted by Avant. RESULTS: The concept of nurse prescription implies prescribing, by the nurse, the best therapeutic regimen for a health problem. This prescription will be guided by the assessment of the health problem, by the criterion of the good clinical practice of the nurse, and will be focused to satisfy the health needs of the patient and the population. CONCLUSIONS: The results clarify the meaning of the study's concept to help professionals understand and address this nursing activity in all its dimensions, and promote social recognition of the nursing profession.

Outcomes after 18 months of eliglustat therapy in treatment-naïve adults with Gaucher disease type 1: The phase 3 ENGAGE trial.

Eliglustat, an oral substrate reduction therapy, is a first-line treatment for adults with Gaucher disease type 1 (GD1) who are poor, intermediate, or extensive CYP2D6 metabolizers (>90% of patients). In the primary analysis of the Phase 3 ENGAGE trial (NCT00891202), eliglustat treatment for 9 months resulted in significant reductions in spleen and liver volumes and increases in hemoglobin concentration and platelet count compared with placebo. We report 18-month outcomes of patients who entered the trial extension period, in which all patients received eliglustat. Of 40 trial patients, 39 entered the extension period, and 38 completed 18 months. Absolute values and percent change over time were determined for spleen and liver volume, hemoglobin concentration, platelet count, bone mineral density, bone marrow burden, and Gaucher disease biomarkers. For patients randomized to eliglustat in the double-blind period, continuing treatment with eliglustat for 9 more months resulted in incremental improvement of all disease parameters. For patients randomized to placebo in the double-blind period, eliglustat treatment during the 9-month, open-label period resulted in significant decrease of spleen and liver volumes and significant increase of hemoglobin and platelets, with a similar rate of change to patients who had received eliglustat in the double-blind period. Eliglustat treatment was also associated with improvement in bone marrow burden score, bone mineral density, and established biomarkers of Gaucher disease, including reduction of the bioactive lipid, glucosylsphingosine. These findings underscore the efficacy of eliglustat in treatment-naïve patients. Eliglustat was well-tolerated, and there were no new safety concerns with longer-term exposure.

Saponinas de quinua (Chenopodium quinoa Willd.): un subproducto con alto potencial biológico / Saponins of Quinoa (Chenopodium quinoa Willd.): a by-product with high biological potential

Las saponinas son un tipo de metabolito secundario ampliamente estudiado por sus reconocidas propiedades biológicas. Gran parte de las investigaciones en fitoquímica están dirigidas a encontrar nuevas fuentes naturales de saponinas con aplicación medicinal. La quinua (Chenopodium quinoa Willd.) es una planta que ha alcanzado un valioso reconocimiento por ser una fuente de alimentos altamente nutritivos, así como una especie rica en saponinas triterpénicas contenidas, principalmente, en la cáscara de las semillas. A la fecha, se han identificado alrededor de 30 saponinas derivadas de la hederagenina y de los ácidos oleanólico, fitolacagénico y serjanico en la planta. El consumo del grano de quinua implica la remoción de la cáscara a fin de reducir su sabor amargo, la ingesta de niveles residuales de saponinas y la obtención de un subproducto rico en las mismas. Esta revisión, inicialmente, ofrece una contex-tualización general de las saponinas; posteriormente, recopila las características estructurales de las saponinas identificadas en la quinua, describe el efecto del procesamiento del grano en su contenido de saponinas y, finalmente, expone los efectos biológicos explorados con extractos de saponinas de quinua, los cuales pueden ser considerados como punto de partida en investigaciones futuras dirigidas al fortalecimiento de su uso en el campo farmacéutico y/o nutracéutico.

Saponins are a type of secondary metabolite that have been widely studied due to their recognized biological properties. Most research into phytochemical has focused on finding new natural sources of saponins with medicinal interest. Quinoa ( Chenopodium quinoa) is a plant that has attained importance as a valuable source of food highly nutritious and rich in triterpenes saponins which are mainly in the outer husks of the seeds. Up to date, about 30 saponins derived from hederagenin, oleanolic acid, phytolaccagenic acid, and serjanic acid have been identified in the plant. Quinoa consumption involves removal of the husk to reduce its bitter taste, the ingestion of residual levels of saponins and obtaining a product rich in saponins. This revision, initially, offers a general contextualization of saponins, then, gathers the structural features of identified saponins in quinoa, describes the effect of the processing of the grain on its saponins content, and finally, exposes the biological properties explored with quinoa saponins extracts which might be considered as a starting point for future investigations aimed at strengthening of their use in the pharmaceutical and/or nutraceutical field.

Comparison of Supraglottic Activity and Spectral Slope Between Theater Actors and Vocally Untrained Subjects.

PURPOSE: The present study aimed to assess supraglottic activity in theater actors and to observe whether they present differences compared with subjects with no voice training. Acoustic and perceptual analyses were also performed. METHODS: A total of 20 participants were divided into two groups: an experimental group of trained theater actors, and a comparative group of subjects with no voice training. Absence of laryngeal pathology was confirmed by rigid videostroboscopy. Flexible laryngoscopy was performed to assess supraglottic activity during speaking phonatory tasks. Voice recording was also carried out. Four blinded judges were asked to assess laryngoscopic and perceptual variables using a visual analog scale. A comparison between groups, phonatory tasks, and loudness levels was performed. RESULTS: Multivariate linear regression showed that trained participants had a higher degree of both laryngeal and pharyngeal activities compared with untrained participants. Moreover, phonatory tasks at high intensity showed higher activity than those at medium and low intensities for most phonatory tasks and laryngoscopic parameters. Vocally trained participants evidenced higher values for all spectral variables compared with untrained participants. CONCLUSION: Actors have a greater degree of both laryngeal and pharyngeal activities than vocally untrained subjects. Apparently, this higher activity is associated to speaking voice training and not to a hyperfunctional vocal behavior. Anterior-posterior laryngeal compression is greater than medial compression. Intensity and phonatory tasks have an effect on all laryngoscopic variables. Supraglottic activity during professional speaking voice may be not necessarily a hyperfunctional behavior, but a strategy to avoid vocal fold damage while producing the desired voice quality.

Effect of oral eliglustat on splenomegaly in patients with Gaucher disease type 1: the ENGAGE randomized clinical trial.

IMPORTANCE: Gaucher disease type 1 is characterized by hepatosplenomegaly, anemia, thrombocytopenia, and skeletal disease. A safe, effective oral therapy is needed. OBJECTIVE: To determine whether eliglustat, a novel oral substrate reduction therapy, safely reverses clinical manifestations in untreated adults with Gaucher disease type 1. DESIGN, SETTING, AND PARTICIPANTS: Phase 3, randomized, double-blind, placebo-controlled trial conducted at 18 sites in 12 countries from November 2009 to July 2012 among eligible patients with splenomegaly plus thrombocytopenia and/or anemia. Of 72 patients screened, 40 were enrolled. INTERVENTIONS: Patients were stratified by spleen volume and randomized 1:1 to receive eliglustat (50 or 100 mg twice daily; n = 20) or placebo (n = 20) for 9 months. MAIN OUTCOMES AND MEASURES: The primary efficacy end point was percentage change in spleen volume in multiples of normal from baseline to 9 months; secondary efficacy end points were change in hemoglobin level and percentage changes in liver volume and platelet count. RESULTS: All patients had baseline splenomegaly and thrombocytopenia (mostly moderate or severe), most had mild or moderate hepatomegaly, and 20% had mild anemia. Least-square mean spleen volume decreased by 27.77% (95% CI, -32.57% to -22.97%) in the eliglustat group (from 13.89 to 10.17 multiples of normal) vs an increase of 2.26% (95% CI, -2.54% to 7.06%) in the placebo group (from 12.50 to 12.84 multiples of normal) for an absolute treatment difference of -30.03% (95% CI, -36.82% to -23.24%; P < .001). For the secondary end points, the least-square mean absolute differences between groups all favored eliglustat, with a 1.22-g/dL increase in hemoglobin level (95% CI, 0.57-1.88 g/dL; P < .001), 6.64% decrease in liver volume (95% CI, -11.37% to -1.91%; P = .007), and 41.06% increase in platelet count (95% CI, 23.95%-58.17%; P < .001). No serious adverse events occurred. One patient in the eliglustat group withdrew (non-treatment related); 39 of the 40 patients transitioned to an open-label extension study. CONCLUSIONS AND RELEVANCE: Among previously untreated adults with Gaucher disease type 1, treatment with eliglustat compared with placebo for 9 months resulted in significant improvements in spleen volume, hemoglobin level, liver volume, and platelet count. The clinical significance of these findings is uncertain, and more definitive conclusions about clinical efficacy and utility will require comparison with the standard treatment of enzyme replacement therapy as well as longer-term follow-up. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00891202.

MODELADO Y SIMULACIÓN DE UN ROBOT TERAPÉUTICO PARA LA REHABILITACIÓN DE MIEMBROS INFERIORES / MODELING AND SIMULATION OF A THERAPEUTIC ROBOT FOR LOWER LIMBS REHABILITATION / MODELAGEM E SIMULAÇÃO DE UM ROBÔ TERAPÊUTICO DE REABILITAÇÃO DE MEMBROS INFERIORES

La rehabilitación en un sentido general tiene el objetivo de reincorporar a una persona a sus actividades de la vida cotidiana. Actualmente, un paciente que requiere de alguna rehabilitación sufre de largas esperas para ser atendido debido a la falta de personal en las clínicas y hospitales. Una alternativa para ayudar al personal médico en las terapias de rehabilitación es utilizando robots terapéuticos. Este artículo muestra el modelado y la simulación de un robot terapéutico para la rehabilitación de miembros inferiores. Se presenta el modelo cinemático y dinámico de un robot de tres grados de libertad con un efector final configurado en paralelo. Se presenta una ley de control por par calculado para el seguimiento de trayectorias planificadas. Se presentan simulaciones de ejercicios terapéuticos para cadera y rodilla realizadas en ADAMS y MATLAB para conocer el comportamiento cinemático y dinámico del robot. Los resultados obtenidos demuestran el gran potencial del robot terapéutico para asistir en la rehabilitación de miembros inferiores.

Rehabilitation in a general sense aims to reinstate a person to their activities of daily living. Currently, a patient that requires a rehabilitation suffers long waits for treatment due to lack of staff in clinics and hospitals. An alternative to assist medical staff in rehabilitation therapies is using therapeutic robots. This paper shows the modeling and simulation of a therapeutic robot for lower limb rehabilitation. The kinematic and dynamic model of a robot of three degrees of freedom with an end-effector configured in parallel is presented. A computed torque control law for a planned trajectory tracking task is presented. Simulations of therapeutic exercises for hip and knee carried out in ADAMS and MATLAB for know the kinematic and dynamic behavior of the robot are presented. The results demonstrate the great potential of the therapeutic robot to assist in the rehabilitation of lower limbs.

A reabilitação de um modo geral tem como objetivo restabelecer uma pessoa para as suas atividades de vida diária. Atualmente, um doente que necessite de alguma reabilitação sofrem com longas esperas para o tratamento devido à falta de pessoal em clínicas e hospitais. Uma alternativa para ajudar a equipe médica em terapias de reabilitação é o uso de robôs terapêuticos. Este artigo mostra o modelado e a simulação de um robô terapêutico para a reabilitação do membro inferior. Apresenta-se também Modelo cinemática e dinâmica de um robô de três graus de liberdade com uma extremidade atuante configurados em paralelo. A lei de controle para o acompanhamento calculados para par planejado trajetórias é apresentado. Simulações de exercícios terapêuticos para substituições de quadril e joelho realizadas em ADAMS e MATLAB para o comportamento cinemático e dinâmico do robô são apresentados. Os resultados demonstram o grande potencial do robô terapêutico para ajudar na reabilitação de membros inferiores.

Addition of 2-deoxyglucose enhances growth inhibition but reverses acidification in colon cancer cells treated with phenformin.

A report that effects of butyrate on some cells may be mediated by activation of AMP-activated protein kinase (AMPK) prompted this study which examines if other AMPK activators can induce differentiation and inhibit proliferation of colon cancer cells in a manner similar to butyrate. Using induction of alkaline phosphatase as a marker, it was observed that compound C, an AMPK inhibitor, is able to reduce the differentiating effect of butyrate on SW1116 and Caco-2 colon cancer cells. Metformin was observed to be less effective than butyrate in the induction of alkaline phosphatase but was more effective as a growth inhibitor. Phenformin was found to be a more potent growth inhibitor than metformin and both compounds cause acidification of the medium when incubated with colon cancer cells. Combined incubation of 2-deoxyglucose with either of the biguanides prevented the acidification of the medium but enhanced the growth inhibitory effects.

Postnatal development of lipopolysaccharide-induced inflammatory response in the brain.

OBJECTIVE: This study aimed to characterize postnatal development of lipopolysaccharide (LPS)-induced inflammatory response in the brain. METHODS: Postnatal day (P)1, P21 and P70 Sprague-Dawley(®) rats were treated with saline or 0.25 mg/kg LPS for 2 h, and the mRNA expression of neuroinflammatory mediators in the brain was determined using reverse transcriptase-polymerase chain reaction (RT-PCR). The kinetics of LPS-induced neuroinflammatory mediators in the brain of P1 and P21 animals was determined using RT-PCR, and the kinetics of LPS-induced cytokines in the serum were determined using ELISA. The basal levels of Toll-like receptor (TLR)-4, CD14, and myeloid differentiation factor 88 (Myd88) were measured at the mRNA and protein levels using RT-PCR and Western blot assay respectively. RESULTS: The mRNA expression levels of cytokines and chemokines were considerably increased in P21 and P70 brains but not significantly altered in P1 brain at 2 h following LPS stimulation. Instead, the induction of cytokines and chemokines was significantly delayed in the brain of P1 animals following LPS stimulation, which was associated with diminished Myd88 production in P1 brain. In parallel, the cytokine response in the serum of P1 animals after LPS stimulation was also delayed compared to P21 animals. CONCLUSIONS: TLR-4-mediated innate immunity in the brain was significantly delayed in P1 animals, and underwent significant development during the early postnatal period.

Altered hepatic inflammatory response in the offspring following prenatal LPS exposure.

There is increasing evidence that maternal immune activation has a significant impact on the offspring's immune function. In this study, we examined the effects of maternal immune activation on the offspring's hepatic inflammatory response. We treated pregnant rats with 500 microg/kg LPS or saline on day 18 of pregnancy, subsequently stimulated the offspring with 250 microg/kg LPS or saline at postnatal day (P) 21, and then examined the expression of LPS cell surface receptors, namely toll-like receptor (TLR)-4 and CD14, and cytokines, namely tumor necrosis factor (TNF)-alpha, interleukin (IL)-1 beta, and IL-6, as well as the activation of key intracellular mediators of the TLR-4 signaling cascade, namely p38 MAPK and p42/44 MAPK, in the offspring liver. We found that LPS-induced mRNA expression of IL-6 in the pups born to LPS-treated dams was significantly diminished compared with that in the pups born to saline-treated dams. Furthermore, maternal immune activation attenuated LPS-induced phosphorylation of p42/44 MAPK compared with the control pups without significantly affecting the phosphorylation of p38 MAPK. The correlation between the level of IL-6 expression and that of phosphorylated p42/44 MAPK suggests that p42/44 MAPK may play an important role in regulating hepatic IL-6 expression. Our results also suggest that maternal immune activation could have differential effects on various inflammatory mediators in the liver of the offspring.

Valoración del diseño del programa de la asignatura psiquiatría en la carrera de medicina / Assessment of the Program Design in the Psychiatry Subject in the Medical Major

Se realiza un análisis del programa de estudio de la asignatura Psiquiatría, en la carrera de medicina, que se imparte en el noveno o décimo semestre de dicha carrera, en un tiempo de 190 horas distribuidas en un período de seis semanas a tiempo completo. Se destacó en el análisis, la carencia en los objetivos del enfoque comunitario que debe tener este programa, si estamos formando un profesional, que desarrollará su trabajo en la comunidad, así como también las necesidades de cambio a realizar en el programa, pues existen temas que deben ser eliminados del programa y utilizarse ese tiempo en otras temáticas. Es de vital importancia que el Médico General Básico posea un amplio conocimiento de temas tales como drogodependencias y urgencias psiquiátricas y dentro de estas últimas en especial la prevención de la conducta suicida, por lo que se hacen las propuestas de modificaciones, así como las formas que deben utilizarse para impartir las mismas.

An analysis of the study program in the Psychiatry Subject is carried out in medical students teaching this subject in the ninth or tenth semester of this major during 190 hours (six weeks, uninterruptedly). The analysis revealed the absence in the objectives of the community approach which this program must have ,because we are training a professional for working in the community, as well as the need of changes in this program, because there are themes which should be eliminated from the program and to have this time in other themes. It is very important for the basic comprehensive doctor to have a vast knowledge on the following themes : drug-abuse and psychiatric emergencies, especially the prevention of suicidal behaviour. so modifications are proposed as well as the ways which must be used for teaching this themes.