Neuromuscular Controller Embedded in a Powered Ankle Exoskeleton:Effects on Gait, Clinical Features and Subjective Perspective of Incomplete Spinal Cord Injured Subjects

Powered exoskeletons are among the emerging technologies claiming to assist functional ambulation. The potential to adapt robotic assistance based on specific motor abilities of incomplete spinal cord injury (iSCI) subjects, is crucial to optimize Human-Robot Interaction (HRI). Achilles, an autonomous wearable robot able to assist ankle during walking, was developed for iSCI subjects and utilizes a NeuroMuscular Controller (NMC). NMC can be used to adapt robotic assistance based on specific residual functional abilities of subjects. The main aim of this pilot study was to analyze the effects of the NMC-controlled Achilles, used as an assistive device, on chronic iSCI participants' performance, by assessing gait speed during 10-session training of robot-aided walking. Secondary aims were to assess training impact on participants' motion, clinical and functional features and to evaluate subjective perspective in terms of attitude towards technology, workload, usability and satisfaction. Results showed that 5 training sessions were necessary to significantly improve robot-aided gait speed on short paths and consequently to optimize HRI. Moreover, the training allowed participants who initially were not able to walk for 6 minutes, to improve gait endurance during Achilles-aided walking and to reduce perceived fatigue. Improvements were obtained also in gait speed during free walking, thus suggesting a potential rehabilitative impact, even if Achilles-aided walking was not faster than free walking. Participants' subjective evaluations indicated a positive experience

Molecular and phylogenetic analysis of HIV-1 variants circulating in Italy

<p>Abstract</p> <p>Objective</p> <p>The continuous identification of HIV-1 non-B subtypes and recombinant forms in Italy indicates the need of constant molecular epidemiology survey of genetic forms circulating and transmitted in the resident population.</p> <p>Methods</p> <p>The distribution of HIV-1 subtypes has been evaluated in 25 seropositive individuals residing in Italy, most of whom were infected through a sexual route during the 1995–2005 period. Each sample has been characterized by detailed molecular and phylogenetic analyses.</p> <p>Results</p> <p>18 of the 25 samples were positive at HIV-1 PCR amplification. Three samples showed a nucleotide divergence compatible with a non-B subtype classification. The phylogenetic analysis, performed on both HIV-1 <it>env </it>and <it>gag </it>regions, confirms the molecular sub-typing prediction, given that 1 sample falls into the C subtype and 2 into the G subtype. The B subtype isolates show high levels of <it>intra</it>-subtype nucleotide divergence, compatible with a long-lasting epidemic and a progressive HIV-1 molecular diversification.</p> <p>Conclusion</p> <p>The Italian HIV-1 epidemic is still mostly attributable to the B subtype, regardless the transmission route, which shows an increasing nucleotide heterogeneity. Heterosexual transmission and the interracial blending, however, are slowly introducing novel HIV-1 subtypes. Therefore, a molecular monitoring is needed to follow the constant evolution of the HIV-1 epidemic.</p

Expert consensus document: A 'diamond' approach to personalized treatment of angina.

In clinical guidelines, drugs for symptomatic angina are classified as being first choice (β-blockers, calcium-channel blockers, short-acting nitrates) or second choice (ivabradine, nicorandil, ranolazine, trimetazidine), with the recommendation to reserve second-choice medications for patients who have contraindications to first-choice agents, do not tolerate them, or remain symptomatic. No direct comparisons between first-choice and second-choice treatments have demonstrated the superiority of one group of drugs over the other. Meta-analyses show that all antianginal drugs have similar efficacy in reducing symptoms, but provide no evidence for improvement in survival. The newer, second-choice drugs have more evidence-based clinical data that are more contemporary than is available for traditional first-choice drugs. Considering some drugs, but not others, to be first choice is, therefore, difficult. Moreover, double or triple therapy is often needed to control angina. Patients with angina can have several comorbidities, and symptoms can result from various underlying pathophysiologies. Some agents, in addition to having antianginal effects, have properties that could be useful depending on the comorbidities present and the mechanisms of angina, but the guidelines do not provide recommendations on the optimal combinations of drugs. In this Consensus Statement, we propose an individualized approach to angina treatment, which takes into consideration the patient, their comorbidities, and the underlying mechanism of disease

Copper, zinc, mercury and arsenic content in Micropogonias furnieri and Mugil platanus of the Montevideo coastal zone, Río de la Plata

Abstract Metals (Cu, Zn, Hg) and metalloid (As) concentrations were measured in Micropogonias furnieri and Mugil platanus caught in three areas along the Montevideo coastal zone during winter 2010, spring 2010 and 2011. Compared to previous studies conducted in the zone, both species showed higher (for Cu), similar (for Zn) or lower (for Hg) concentrations. The highest Hg values were found in the M. furnieri of Montevideo bay. There was no spatial variation in Cu, Zn, and As concentrations in muscle, likely due to the high mobility of both species. However, the Cu content in the liver of M. furnieri was higher in fish from the West zone. Cu, Zn and As found in the liver of M. platanus were much higher than in that of M. furnieri. A functional relationship between muscle levels of Zn and Hg and fish length of M. furnieri indicates bioaccumulation of these metals. According to the results, M. furnieri may be used as a temporal bioindicator for Hg, but not as a spatial bioindicator. Mercury levels were below the maximum safety level based on international standard values for human consumption

Effects of immobilization and cold exposure on the turnover rate of acetylcholine in rat brain areas

The effect of two 'Stressors', immobilization and cold exposure, on the turnover rate of acetylcholine in various brain areas has been determined. Neither short term (10 min) nor long term (1 24 h) immobilization stress modifies the acetylcholine or choline concentrations or the turnover rate of acetylcholine in various rat brain areas. Cold exposure reduces the turnover rate of acetylcholine in the hypothalamus and modifies some of the other cholinergic parameters (e.g. choline content or fractional rate constant for acetylcholine efflux) in all areas studied. These results suggest that cholinergic neurons may be involved in thermoregulation but may not necessarily be involved in the phenomenon of immobilization stress. \ua9 1981