AAU-BOT1:a platform for studying dynamic, life-like walking

This paper describes the development of the humanoid robot AAU-BOT1. The purpose of the robot is to investigate human-like walking and in this connection, test prosthetic limbs. AAU-BOT1 has been designed with modularity in mind making it possible to replace, e.g. the lower leg to test transfemoral or transtibial prosthesis or orthosis. Recorded motion data from a male test person, along with approximated inertial and mass properties, were used to determine necessary joint torques in human walking which was used as design parameters for the robot. The robot has 19 degrees of freedom (DoF), 17 actuated and 2 unactuated acting as passive toe joints. The project was granted 60,000 Euro, and to keep development costs below this, the development and instrumentation was carried out by three groups of master students from the Department of Mechanical Engineering (ME) and the Department of Electronic Systems at Aalborg University and supported by the Department of Health Sciences and Technology (HST). To further reduce the cost, the robot uses off-the-shelf hardware which also reduced the time from idea to practical implementation. The result is a low-cost humanoid robot fully assembled and equipped with sensors ready to take its first steps

Factors influencing preoperative stress response in coronary artery bypass graft patients

BACKGROUND: In many studies investigating measures to attenuate the hemodynamic and humoral stress response during induction of anaesthesia, primary attention was paid to the period of endotracheal intubation since it has been shown that even short-lasting sympathetic cardiovascular stimulation may have detrimental effects on patients with coronary artery disease. The aim of this analysis was, however, to identify the influencing factors on high catecholamine levels before induction of anaesthesia. METHODS: Various potential risk factors that could impact the humoral stress response before induction of anaesthesia were recorded in 84 males undergoing coronary aortic bypass surgery, and were entered into a stepwise linear regression analysis. The plasma level of norepinephrine measured immediately after radial artery canulation was chosen as a surrogate marker for the humoral stress response, and it was used as the dependent variable in the regression model. Accordingly, the mean arterial blood pressure, heart rate and the calculated pressure-rate product were taken as parameters of the hemodynamic situation. RESULTS: Stepwise regression analysis revealed that the oral administration of low-dose clonidine (mean dose 1.75 μg·kg(-1)) on the morning of surgery was the only significant predictor (p = 0.004) of the high variation in preoperative norepinephrine plasma levels. This intervention decreased norepinephrine levels by more than 40% compared to no clonidine administration, from 1.26 to 0.75 nmol·l(-1). There was no evidence for dose-responsiveness of clonidine. All other potential predictors were removed from the model as insignificant (p > 0.05). The use of beta-blocker, ace-inhibitors, ejection fraction, and body mass index were significant determinants for the hemodynamic situation (heart rate, mean arterial pressure, pressure rate product) of the patient during the pre-induction period. CONCLUSION: The oral administration of clonidine is the only significant predictor for the observed variation of norepinephrine levels during the preoperative period. Lack of significant dose responsiveness suggests that even a low dose of the drug can attenuate the preoperative stress response and thus is recommended in cardiovascular high risk patients

The Area method: a new method for ultrasound assessment of diaphragmatic movement

Abstract Background Ultrasound can be used to assess diaphragm movement. Existing methods focus on movement at a single point at the hemidiaphragm and may not consider the anatomic and functional complexity. We aimed to develop an ultrasound method, the Area method, to assess movement of the entire hemidiaphragm dome and to compare it with existing methods to evaluate accuracy, inter-rater agreement, and feasibility. Methods Movement of the diaphragm was evaluated by ultrasonography in 19 healthy subjects and correlated with simultaneously performed spirometry. Two existing methods, the M-mode excursion at the posterior part of diaphragm and the B-mode at the top of the diaphragm, were compared with the Area method. Two independent raters reviewed film clips to analyze inter-rater agreement. Feasibility was tested by novice ultrasound operators. Results Correlation with expired lung volume was higher with the Area method, 0.88 (95% CI 0.81–0.95), p < 0.001, and with the M-mode measurement, 0.84 (95% CI 0.75–0.92), p < 0.001, than with the B-mode measurement, 0.71 (95% CI 0.59–0.83), p < 0.001. Inter-rater agreement was highest with the Area method, 0.9, p < 0.001, and M-mode measurement 0.9, p < 0.001, and lower with the B-mode measurement, 0.8, p < 0.001. The M-mode measurement could be done in only 20% at the left side. The Area method could be performed in all participants at both hemidiaphragms, and novice operators found it easy to perform. Conclusion A new method to evaluate diaphragm movement is introduced. Accuracy and inter-rater agreement are high. The Area method is equally feasible at both hemidiaphragms in contrast to existing methods. However, additional studies should include more participants, different types of pulmonary diseases, and investigate the role of patient position to validate the Area method fully

The effect of focused lung ultrasonography on antibiotic prescribing in patients with acute lower respiratory tract infections in Danish general practice:study protocol for a pragmatic randomized controlled trial (PLUS-FLUS)

Background: The use of antibiotics is a key driver of antimicrobial resistance and is considered a major threat to global health. In Denmark, approximately 75% of antibiotic prescriptions are issued in general practice, with acute lower respiratory tract infections (LRTIs) being one of the most common indications. Adults who present to general practice with symptoms of acute LRTI often suffer from self-limiting viral infections. However, some patients have bacterial community-acquired pneumonia (CAP), a potential life-threatening infection, that requires immediate antibiotic treatment. Importantly, no single symptom or specific point-of-care test can be used to discriminate the various diagnoses, and diagnostic uncertainty often leads to (over)use of antibiotics. At present, general practitioners (GPs) lack tools to better identify those patients who will benefit from antibiotic treatment. The primary aim of the PLUS-FLUS trial is to determine whether adults who present with symptoms of an acute LRTI in general practice and who have FLUS performed in addition to usual care are treated less frequently with antibiotics than those who only receive usual care. Methods: Adults (≥ 18 years) presenting to general practice with acute cough (&lt; 21 days) and at least one other symptom of acute LRTI, where the GP suspects a bacterial CAP, will be invited to participate in this pragmatic randomized controlled trial. All participants will receive usual care. Subsequently, participants will be randomized to either the control group (usual care) or to an additional focused lung ultrasonography performed by the GP (+ FLUS). The primary outcome is the proportion of participants with antibiotics prescribed at the index consultation (day 0). Secondary outcomes include comparisons of the clinical course for participants in groups. Discussion: We will examine whether adults who present with symptoms of acute LRTI in general practice, who have FLUS performed in addition to usual care, have antibiotics prescribed less frequently than those given usual care alone. It is highly important that a possible reduction in antibiotic prescriptions does not compromise patients’ recovery or clinical course, which we will assess closely. Trial registration: ClinicalTrials.gov NCT06210282. Registered on January 17, 2024.</p