Gait variability is altered in patients with peripheral arterial disease

Objective Claudication is the most common presentation of peripheral arterial disease (PAD), producing significant ambulatory compromise. Claudicating patients, most of whom are elderly, have reduced mobility and poor health outcomes, including an increased risk of falls. The gait of elderly fallers is characterized by increased variability. Increase in the variability of the locomotor system makes the gait more noisy and unstable. The purpose of this study is to investigate gait variability in patients with PAD. Methods Nineteen symptomatic PAD patients (age, 63.6 ± 9.8 years; body mass, 82.1 ± 18.5 kg; height, 1.71 ± 0.06 m) walked on a treadmill in the absence of pain or claudication symptoms while joint flexion and extension kinematics were captured. Results were compared with results obtained from 17 matched healthy controls (age, 65.2 ± 12.5 years; body mass, 82.0 ± 25.9.5 kg; height, 1.73 ± 0.08 m). Relative joint angles were calculated for the ankle, knee, and hip flexion/extension, and the stride-to-stride variability of joint flexion and extension was calculated from at least 30 consecutive footfalls. Variability was expressed using the largest Lyapunov exponent, standard deviation, and coefficient of variation. Independent t tests were used to compare gait variability between groups. Results Symptomatic PAD patients had significantly higher largest Lyapunov exponent values and coefficient of variation values for all joints, and higher standard deviation values at the ankle and the hip (P \u3c .05). Conclusion Symptomatic PAD patients have increased gait variability at the ankle, knee, and hip joints at baseline ambulation in the absence of claudication pain. Our findings indicate significant baseline deterioration in the locomotor system of symptomatic PAD patients. This deterioration results in increased noise and instability of gait and is a potential contributing factor to the falls and mobility problems experienced by symptomatic PAD patients

The Networked Nitrous Node: A Low-Power Field-Deployable COTS-based N2O gas sensor platform

We present a wireless nitrous oxide (N 2 O) gas sensor system consisting of a commercial high-current infrared N 2 O sensor wrapped in a “smart” sensor framework to make it suitable for battery-powered deployment. This framework consists of wireless mesh networking, data storage, additional environmental sensors, and a gas sensor power control circuit managed by a central microcontroller. The N 2 O sensor is the first order consumer of power and sampling N 2 O at approximately ten minute intervals yields an estimated system lifetime of 63 days when using four 18650 Li-ion batteries. The node stores data locally on SD card and wirelessly reports to a root PC that also stores data and displays to users in a simple graphical user interface. The system is composed of majority off-the-shelf components and any custom components were designed or programmed with open-source software. We expect these features will lead to this system being more easily understood, copied, and modified by engineers wishing to design similar sensor system frameworks and thereby allow even more power-prohibitive devices to be wirelessly deployed

Enhanced Motor Function by Training in Spinal Cord Contused Rats Following Radiation Therapy

Weight-bearing stepping, without supraspinal re-connectivity, can be attained by treadmill training in an animal whose spinal cord has been completely transected at the lower thoracic level. Repair of damaged tissue and of supraspinal connectivity/circuitry following spinal cord injury in rat can be achieved by specific cell elimination with radiation therapy of the lesion site delivered within a critical time window, 2-3 weeks postinjury. Here we examined the effects of training in the repaired spinal cord following clinical radiation therapy. Studies were performed in a severe rat spinal cord contusion injury model, one similar to fracture/crush injuries in humans; the injury was at the lower thoracic level and the training was a combined hindlimb standing and stepping protocol. Radiotherapy, in a similar manner to that reported previously, resulted in a significant level of tissue repair/preservation at the lesion site. Training in the irradiated group, as determined by limb kinematics tests, resulted in functional improvements that were significant for standing and stepping capacity, and yielded a significant direct correlation between standing and stepping performance. In contrast, the training in the unirradiated group resulted in no apparent beneficial effects, and yielded an inverse correlation between standing and stepping performance, e.g., subject with good standing showed poor stepping capacity. Further, without any training, a differential functional change was observed in the irradiated group; standing capacity was significantly inhibited while stepping showed a slight trend of improvement compared with the unirradiated group. These data suggest that following repair by radiation therapy the spinal circuitries which control posture and locomotor were modified, and that the beneficial functional modulation of these circuitries is use dependent. Further, for restoring beneficial motor function following radiotherapy, training seems to be crucial

Assessment of the flotability of chalcopyrite, molybdenite and pyrite using biosolids and their main components as collectors for greening the froth flotation of copper sulphide ores.

Biosolids and representative compounds of their main components ? humic acids, sugars, and proteins ? have been tested as possible environment-friendly collectors and frothers for the flotation of copper sulphide ores. The floatability of chalcopyrite and molybdenite ? both valuable sulphide minerals present in these ores ? as well as non-valuable pyrite was assessed through Hallimond tube flotation tests. Humic acids exhibit similar collector ability for chalcopyrite and molybdenite as that of a commercial collector (Aero 6697 promoter). Biosolids show more affinity for pyrite. The copper recovery (85.9%) and copper grade (6.7%) of a rougher concentrate obtained using humic acids as main collector for the flotation of a copper sulphide ore from Chile, were very similar to those of a copper concentrate produced by froth flotation under the same conditions with a xanthate type commercial collector. This new and feasible end-use of biosolids and humic acids should be new environment-friendly organic froth flotation agents for greening the concentration of copper sulphide ore. Now, further research is needed in order to scale current laboratory assays to operational mining scales to determine efficiencies to industrial scale

Adsorption of biosolids and their main components on chalcopyrite, molybdenite and pyrite: Zeta potential and FTIR spectroscopy studies

Zeta potential measurements were used to assess the electrokinetic characteristics of chalcopyrite, molybdenite and pyrite in the presence of biosolids and their main components (humic acids, glucose and serum albumin) as well as a commercial collector (Aero 6697). Fourier transform infrared spectroscopy (FTIR) was then used to gain a deeper understanding of the interaction of these compounds with these sulfide minerals. It aims to achieve a better understanding of the surface chemistry of sulfide–water interfaces that improve froth flotation at industrial scale in the step of copper sulfide ore concentration. Zeta potential results show that hydrogen and hydroxide ions are potential determining ions for each sulfide mineral studied. The addition of 50 g/t biosolids or all the other chemicals used in this investigation shift the isoelectric point of chalcopyrite. Under the same conditions, only humic acid significantly affects the zeta potential of molybdenite, making it more negative in the pH range investigated, and shifting its isoelectric point about 6 pH units. These compounds seem to have a poor affinity with pyrite surfaces because their zeta potential is slightly modified. FTIR spectroscopy characterization shows that biosolids and their main components can interact with chalcopyrite, molydenite and pyrite surfaces through a complex mechanism involving chemical or physical linkages. The results reported here seem to indicate that biosolids may be used as new environment-friendly froth flotation agents to concentrate copper and molybdenum sulfide mineral

Evaluación y requerimientos nutricionales en pacientes hospitalizados por COVID-19

La COVID-19 desencadena un cuadro clínico que puede impactar negativamente en el estado nutricional y en el pronóstico de los pacientes. La respuesta inflamatoria exacerbada en casos críticos, puede traer consigo una serie de alteraciones metabólicas y catabólicas que afectan directamente el estado nutricional, generando pérdida de masa muscular esquelética y desnutrición, lo que se asocia a peores desenlaces y mayores complicaciones. La valoración del estado nutricional, mediante el tamizaje y la evaluación nutricional en pacientes con COVID-19, nos permite preservar el estado nutricional y/o prevenir o tratar la desnutrición asociada y así, reducir las complicaciones asociadas a la misma. Actualmente no existe tratamiento nutricional específico frente al COVID-19, sin embargo, las diversas sociedades científicas del mundo han establecido una serie de recomendaciones para confrontar la situación nutricional. Así, en el presente trabajo se exponen los requerimientos nutricionales en pacientes con COVID-19 no ventilados en hospitalización general y en la Unidad de Cuidados Intensivos (UCI) en base al aporte de energía, carbohidratos, proteínas, lípidos y micronutrientes (vitaminas y minerales) necesarios para mejorar su pronóstico durante la estancia hospitalaria. Palabras claves: Evaluación Nutricional, Necesidades Nutricionales, Infección por Coronavirus 2019-nCoV. (fuente: DeCS)   DOI: http://dx.doi.org/10.17268/rmt.2021.v16i03.1

Gamma-ray and radio properties of six pulsars detected by the fermi large area telescope

We report the detection of pulsed γ-rays for PSRs J0631+1036, J0659+1414, J0742-2822, J1420-6048, J1509-5850, and J1718-3825 using the Large Area Telescope on board the Fermi Gamma-ray Space Telescope (formerly known as GLAST). Although these six pulsars are diverse in terms of their spin parameters, they share an important feature: their γ-ray light curves are (at least given the current count statistics) single peaked. For two pulsars, there are hints for a double-peaked structure in the light curves. The shapes of the observed light curves of this group of pulsars are discussed in the light of models for which the emission originates from high up in the magnetosphere. The observed phases of the γ-ray light curves are, in general, consistent with those predicted by high-altitude models, although we speculate that the γ-ray emission of PSR J0659+1414, possibly featuring the softest spectrum of all Fermi pulsars coupled with a very low efficiency, arises from relatively low down in the magnetosphere. High-quality radio polarization data are available showing that all but one have a high degree of linear polarization. This allows us to place some constraints on the viewing geometry and aids the comparison of the γ-ray light curves with high-energy beam models

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to &lt;90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], &gt;300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of &lt;15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P&lt;0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P&lt;0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years