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Design and Implementation of a Rehabilitation Upper-limb Exoskeleton Robot Controlled by Cognitive and Physical Interfaces

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Journal of Bionic Engineering 2022年第5期19卷 1374-1391页

作者： arturo Gonzalez‑Mendoza Ivett Quinones‑Uriostegui Sergio Salazar‑Cruz Alberto‑Isaac Perez‑Sanpablo Ricardo Lopez‑Gutierrez Rogelio lozano LAFMIA UMI Center for Research and AdvancedStudies of National Polytechnic InstituteAv.Instituto Politecnico Nacional No.250807360 Mexico CityMexico Motion Analysis Lab National Institute of Rehabilitation Luis Guillermo Ibarra IbarraCalz.Mexico Xochimilco No.28914389 Mexico CityMexico CONACYT-CINVESTAV Av.Instituto Politecnico Nacional 250807360 Mexico CityMexico UTC-CNRS UMR Sorbonne UniversitesUTC-CNRS UMR7253 HeudiasycCompiegneFrance

This paper presents an upper limb exoskeleton that allows cognitive(through electromyography signals)and physical user interaction(through load cells sensors)for passive and active exercises that can activate neuroplasticity in the rehabilitation process of people who suffer from a neurological injury.For the exoskeleton to be easily accepted by patients who suffer from a neurological injury,we used the ISO9241-210:2010 as a methodology design process.As the first steps of the design process,design requirements were collected from previous usability tests and literature.Then,as a second step,a technological solution is proposed,and as a third step,the system was evaluated through performance and user testing.As part of the technological solution and to allow patient participation during the rehabilitation process,we have proposed a hybrid admittance control whose input is load cell or electromyography signals.The hybrid admittance control is intended for active therapy exercises,is easily implemented,and does not need musculoskeletal modeling to work.Furthermore,electromyography signals classification models and features were evaluated to identify the best settings for the cognitive human–robot interaction.

关键词： Human Robot interaction Hybrid admittance control Surface electromyography Upper-limb exoskeletal robot

Management of Complex Wounds with Dermal Substitute Assisted by a Negative Pressure System

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Modern Plastic Surgery 2023年第4期13卷 95-105页

作者： Cuahutémoc Márquez Espriella Ruiz Garza Jorge Gerardo Barbosa Villarreal Fernando Dávila Díaz Rodrigo Cuervo Vergara Marco Antonio Campollo López Ana Priscila Gutierrez Alvarez Mauricio Chama Naranjo Alfredo García Corral Jesús Ricardo Pérez Benítez Omar Alberto Pulido López Ricardo Alberto Jaimes Duran Edwing Michel Garibaldi Bernot Mauro Cortes Aguilar Carlos Manuel García Córdova Carlos Emiliano Camacho Rodriguez Hayah Camacho Rodriguez Hayah Martinez Villalobos Claudia Nallely Ochoa Contreras Erick Cesar Randall Cruz Soto herrera lozano luis arturo Department of Plastic and Reconstructive Surgery Hospital Central Sur Petróleos Mexicanos Mexico City Mexico

Introduction: The standard treatment for complex wound care is autografting. The advent of dermal substitutes has provided a novel tool for the preparation of the bed to be grafted. However, most types of dermal matrices require the application of a skin graft a second time. Currently, other strategies have been developed to improve the vascularization process, such as negative pressure wound therapy (NPWT), which has been reported to reduce the time required for vascular growth and dermal matrix integration and thus achieve a shorter waiting period for autologous graft application. The present study aims to evaluate the effectiveness and safety of dermal matrix management associated with NPWT in the treatment of complex wounds. Methods: Seven patients with a diagnosis of complex wounds were enrolled in this study between July 1, 2015, and June 31, 2016. After debridement and having an adequate wound bed, patients who met the criteria for the application of combined therapy were treated with dermal substitutes and a negative pressure system. The percentage of graft integration into the wound bed, complications, length of hospital stay, and duration of therapy were analyzed. Results: The mean age was 42.5 ± 16 (39 - 54) years old;three women and four men were included in the study. The approximate size of skin loss was 120.7 ± 75 cm2 (25 - 250 cm2). The combined therapy of dermal matrix plus NPWT was instituted in all cases for a period of 14 days. There were no complications, with 100% graft integration in 6 of 7 cases. Patients were discharged after a mean hospital stay of 5.4 days. Conclusions: This study demonstrates that the utilization of combined dermal matrix plus NPWT therapy can be performed safely and effectively in patients with complex wounds with low complication rates and a short hospital stay.

关键词： Negative Pressure Wound Therapy Complex Wound Dermal Matrix Wound Therapy

Assessment of diagnostic capacity and decision-making based on the 2015 American Thyroid Association ultrasound classification system

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World Journal of Methodology 2022年第3期12卷 148-163页

作者： luis-Mauricio Hurtado-Lopez Alfredo Carrillo-Muñoz Felipe-Rafael Zaldivar-Ramirez Erich Otto Paul Basurto-Kuba Blanca-Estela Monroy-lozano Department of Surgery Thyroid ClinicHospital General de MexicoMexico City 06720Mexico Thyroid Clinic General Surgery ServiceHospital General de MexicoMexico 06726Mexico

BACKGROUND This study evaluates the American Thyroid Association(ATA)ultrasound(US)classification system for the initial assessment of thyroid nodules to determine if it indeed facilitates clinical decision-making.AIM To perform a systematic review and meta-analysis of the diagnostic value of the ATA US classification system for the initial assessment of thyroid nodules.METHODS In accordance with the PRISMA statement for diagnostic test accuracy,we selected articles that evaluated the 2015 ATA US pattern guidelines using a diagnostic gold standard.We analyzed these cases using traditional diagnostic parameters,as well as the threshold approach to clinical decision-making and decision curve analysis.RESULTS We reviewed 13 articles with 8445 thyroid nodules,which were classified according to 2015 ATA patterns.Of these,46.62%were malignant.No cancer was found in any of the ATA benign pattern nodules.The Bayesian analysis post-test probability for cancer in each classification was:(1)Very-low suspicion,0.85%;(2)Low,2.6%;(3)Intermediate,6.7%;and(4)High,40.9%.The net benefit(NB),expressed as avoided interventions,indicated that the highest capacity to avoid unnecessary fine needle aspiration biopsy(FNAB)in the patterns that we studied was 42,31,35,and 43 of every 100 FNABs.The NB calculation for a probability threshold of 11%for each of the ATA suspicion patterns studied is less than that of performing FNAB on all nodules.CONCLUSION These three types of analysis have shown that only the ATA high-suspicion diagnostic pattern is clinically useful,in which case,FNAB should be performed.However,the curve decision analysis has demonstrated that using the ATA US risk patterns to decide which patients need FNAB does not provide a greater benefit than performing FNAB on all thyroid nodules.Therefore,it is likely that a better way to approach the assessment of thyroid nodules would be to perform FNAB on all non-cystic nodules,as the present analysis has shown the ATA risk patterns do not provide an adequate clinical decision-ma

关键词： Thyroid nodule Thyroid cancer Ultrasound Bayesian analysis Systematic review Metaanalysis

Molecular Docking Studies of Estrone-Coumarin Derivatives as Aromatase and 17β-HSD1 Inhibitors Related to Hormone Receptor Positive (HR+) Breast Cancer

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Advances in Enzyme Research 2022年第4期10卷 83-100页

作者： Silvia Alejandra Meza-Ireta Blanca Colin-lozano Penélope Merino-Montiel José luis Vega-Báez Sara Montiel-Smith Facultad de Ciencias Químicas Ciudad Universitaria Benemérita Universidad Autónoma de Puebla Puebla México

Hormone Receptor positive (HR+) breast cancer is the most common malignancy in women. New strategies in the treatments have targeted the estrogen biosynthesis pathways including the inhibition of the aromatase and 17β-HSD1 enzymes. The present work, describes the study of a new family of 9 hybrid compounds derived from estrone attached to a coumarin fragment, linked through different lengths of hydrocarbon chains. The activity of these compounds was evaluated by molecular docking with two relevant enzymes in breast cancer (HR+). It has been proposed nine compounds as 17β-HSD1 inhibitors and six as aromatase inhibitors. We found important interactions with key amino acids at the orthosteric site of each enzyme and their score values compared to the crystallographic ligand. The in silico analysis showed good score values in the proposed compounds, where the steroidal portion presented important interactions with Met374 and Tyr155 in aromatase and in 17β-HSD1 respectively. Highlighting Compounds 2, 5 and 8 with an aromatic ring at the C4 position of the coumarin moiety, which favored arene-H type interactions essential for protein-ligand recognition. In addition, the results related to the 17β-HSD1 enzyme demonstrated how the length of the linker influences the interaction;the best score was found for derivative 8 with a chain of 8 methylenes.

关键词： Estrone Coumarins Aromatase Inhibitors 17β-HSD1 Inhibitors Molecular Docking

Association between physical activity and cardiovascular risk factors:Dose and sex matter

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Journal of Sport and Health Science 2021年第5期10卷 604-606页

作者： Alejandro Santos-lozano Alberto Torres Barran Pablo Fernandez-Navarro Pedro L.Valenzuela Adrian Castillo-Garcia luis MRuilope David Rios Insua Jose M.Ordovas Victoria Ley Alejandro Lucia i+HeALTH Department of Health SciencesEuropean University Miguel de CervantesValladolid 47012Spain Research Institute of the Hospital 12 de Octubre(imas12 PaHerg group)and(CIBER en Fragilidad y Envejecimiento Saludable-CIBEFES)Madrid 28041Spain Institute of Mathematical Sciences(ICMAT-CSIC) Madrid 28049Spain d Cancer and Environmental Epidemiology Unit National Center for EpidemiologyCarlos III Institute of HealthMadrid 28029Spain Consortium for Biomedical Research in Epidemiology&Public Health(CIBER en Epidemiologia y Salud Publica-CIBERESP) Madrid 28029Spain Department of Systems Biology University of AlcalaMadrid 28801Spain Fissac-Physiology Health and Physical ActivityMadrid 28801Spain Hypertension Unit and Cardiorenal Translational Laboratory Research Institute of the Hospital 12 de Octubre(imas12)Madrid 28041Spain Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University BostonMA 02111USA Spanish State Research Agency Ministry of ScienceInnovation and UniversitiesMadrid 28046Spain Faculty of Sport Sciences Universidad Europea de MadridMadrid 28670Spain

Dear Editor,ETadegn TagedPFailure to meet World Health Organization(WHO)-determined minimum physical activity(PA)levels is an established risk factor for cardiovascular disease(CVD),^(1)but evidence is still scarce on its effects on other CVD risk factors.Furthermore,whether or not there are sex-specific effects on the association between PA and CVD risk is a matter of controversy,with some authors observing a protective effect of PA in men but not in women,^(2)and others finding the opposite trend.^(3)

关键词： cardiovascular protective finding

Managament Wound Healing: The Importance of a Wound Clinic in Hospital Centers

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现代整形外科(英文) 2023年第4期13卷 118-125页

作者： Alfredo Chama Naranjo Cuahutémoc Márquez Espriella Alberto Ignacio Cahuana Quispe Barbosa Villarreal Fernando Ana Priscila Campollo López Mauricio Gutiérrez Álvarez Carlos Emiliano García Córdova Jesús Ricardo García Corral Cuervo Vergara Marco Antonio Jorge luis Rosales Becerra Dávila Díaz Rodrigo Edgar Alan Guillen Martínez Marín Canto Miguel Eduardo luis arturo herrera lozano Ochoa Contreras Erick Cesar Martinez Villalobos Claudia Nallely Cruz Soto Randall Camacho Rodriguez Hayah Ricardo Alberto Pulido López Edwing Michel Jaimes Durán Department of Plastic and Restrictive Surgery Hospital Central Sur de Alta Especialidad Pemex Mexico City Mexico

Background: In clinical practice, acute and chronic wounds continue to be a challenge. Unfortunately, wound care is often inadequate or inappropriate. The implementation of wound clinics involving an interdisciplinary team for wound care and treatment yields favorable clinical outcomes as well as a reduction in economic expenses due to a higher rate of healing, a decrease in hospital stays, and a reduction in the number of readmissions. The establishment of wound clinics enhances the utilization of diagnostic, preventive, and therapeutic resources, improving the quality of life of patients and facilitating their reintegration into their normal lives. The objective is solely to describe the importance of wound clinics in the medical profession. Methods: A retrospective literature search was conducted to include articles no more than 10 years old that reported measures or results of the study in order to perform a literature review and describe the importance of wound clinics in medical practice. Results: A total of 7 articles were obtained with the inclusion criteria, the most recent being from the year 2023 and the oldest from 2013. Conclusion: An important area for improvement in the healthcare industry is the management and treatment of complex wounds. The establishment of wound clinics offers comprehensive and specialized care for both acute and chronic complex wounds with the goal of enhancing secondary illness patients’ prevention, treatment, and rehabilitation.

关键词： Wound Clinic Pressure Ulcer Chronic Wound Wound Healing Quality of Life

Hepatic flow is an intraoperative predictor of early allograft dysfunction in whole-graft deceased donor liver transplantation: An observational cohort study

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World Journal of Hepatology 2019年第9期11卷 689-700页

作者： Pablo lozano Lominchar Maitane Igone Orue-Echebarria Lorena Martín Cristina Julia Lisbona María Magdalena Salcedo luis Olmedilla Hemant Sharma Jose Manuel Asencio JoséAngel López-Baena General Surgery Department Liver Transplant UnitHospital General Universitario Gregorio MaranonMadrid 28007Spain Anesthesiology Department Liver Transplant UnitHospital General Universitario Gregorio MaranonMadrid 28007Spain Hepatology Department Liver Transplant UnitHospital General Universitario Gregorio MaranonMadrid 28007Spain Department of Transplant Surgery Oschner Medical CenterNew OrleansLA 70816United States

BACKGROUND Early allograft dysfunction(EAD)after liver transplantation(LT)is an important cause of morbidity and mortality.To ensure adequate graft function,a critical hepatocellular mass is required in addition to an appropriate blood supply.We hypothesized that intraoperative measurement of portal venous and hepatic arterial flow may serve as a predictor in the diagnosis of EAD.AIM To study whether hepatic flow is an independent predictor of EAD following LT.METHODS This is an observational cohort study in a single institution.Hepatic arterial blood flow and portal venous blood flow were measured intraoperatively by transit flow.EAD was defined using the Olthoff criteria.Univariate and multivariate analyses were used to determine the intraoperative predictors of EAD.Survival analysis and prognostic factor analysis were performed using the Kaplan-Meier and Cox regression models.RESULTS A total of 195 liver transplant procedures were performed between January 2008 and December 2014 in 188 patients.A total of 54(27.7%)patients developed EAD.The median follow-up was 39 mo.Portal venous flow,hepatic arterial flow(HAF)and total hepatic arterial flow were associated with EAD in both the univariate and multivariate analyses.HAF is an independent prognostic factor for 30-d patient mortality.CONCLUSION Intraoperative measurement of blood flow after reperfusion appears to be a predictor of EAD;Moreover,HAF should be considered a predictor of 30-d patient mortality.

关键词： Hepatic flow Early allograft dysfunction Liver transplant

Intertwined leukocyte balances in tumours and peripheral blood as robust predictors of right and left colorectal cancer survival

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World Journal of Gastrointestinal Oncology 2022年第1期14卷 295-318页

作者： Ramón Cantero-Cid Karla Marina Montalbán-Hernández Jenny Guevara Alejandro Pascual-Iglesias Elisa Pulido JoséCarlos Casalvilla Cristóbal Marcano Cristina Barragán Serrano Jaime Valentín Gloria Cristina Bonel-Pérez JoséAvendaño-Ortiz Verónica Terrón Roberto lozano-Rodríguez Alejandro Martín-Quirós Elvira Marín Eva Pena Laura Guerra-Pastrián Eduardo López-Collazo luis Augusto Aguirre Tumor Immunology Laboratory The Innate Immune Response GroupHospital La Paz Institute for Health Research(IdiPAZ)Madrid 28046Spain Digestive Surgery Service La Paz University HospitalMadrid 28046Spain Emergency Department and Emergent Pathology Research Group Hospital La Paz Institute for Health Research(IdiPAZ)Madrid 28046Spain Pathologic Anatomy Service Hospital La PazMadrid 28046Spain

BACKGROUND Colorectal cancer(CRC)accounts for 9.4%of overall cancer deaths,ranking second after lung cancer.Despite the large number of factors tested to predict their outcome,most patients with similar variables show big differences in survival.Moreover,right-sided CRC(RCRC)and left-sided CRC(LCRC)patients exhibit large differences in outcome after surgical intervention as assessed by preoperative blood leukocyte status.We hypothesised that stronger indexes than circulating(blood)leukocyte ratios to predict RCRC and LCRC patient outcomes will result from combining both circulating and infiltrated(tumour/peritumour fixed tissues)concentrations of leukocytes.AIM To seek variables involving leukocyte balances in peripheral blood and tumour tissues and to predict the outcome of CRC patients.METHODS Sixty-five patients diagnosed with colon adenocarcinoma by the Digestive Surgery Service of the La Paz University Hospital(Madrid,Spain)were enrolled in this study:43 with RCRC and 22 with LCRC.Patients were followed-up from January 2017 to March 2021 to record overall survival(OS)and recurrence-free survival(RFS)after surgical interventions.Leukocyte concentrations in peripheral blood were determined by routine laboratory protocols.Paraffin-fixed samples of tumour and peritumoural tissues were assessed for leukocyte concentrations by immunohistochemical detection of CD4,CD8,and CD14 marker expression.Ratios of leukocyte concentration in blood and tissues were calculated and evaluated for their predictor values for OS and RFS with Spearman correlations and Cox univariate and multivariate proportional hazards regression,followed by the calculation of the receiver-operating characteristic and area under the curve(AUC)and the determination of Youden’s optimal cutoff values for those variables that significantly correlated with either RCRC or LCRC patient outcomes.RCRC patients from the cohort were randomly assigned to modelling and validation sets,and clinician-friendly nomograms were developed to predict OS and RFS from the

关键词： Left colorectal cancer Leukocyte ratios Prognostic variables Recurrence-free survival Right colorectal cancer Overall survival

Structure of Ligand-Bound Intermediates of Crop ABA Receptors Highlights PP2C as Necessary ABA Co-receptor

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Molecular Plant 2017年第9期10卷 1250-1253页

作者： María Moreno-Alvero Cristina Yunta Miguel Gonzalez-Guzman Jorge lozano-Juste Juan luis Benavente Vicent Arbona Margarita Menéndez Martin Martinez-Ripoll Lourdes Infantes Aurelio Gomez-Cadenas Pedro L. Rodriguez Armando Albert Instituto de Química Física Rocasolano Consejo Superior de Investigaciones Científicas 28006 Madrid Spain Instituto de Biología Molecular y Celular de Plantas Consejo Superior de Investigaciones Científicas-Universidad Politécnica de Valencia 46022 Valencia Spain Biotecnologia Departament Ciències Agràries i del Medi Natural Universitat Jaume I 12071 Castelló de la Plana Spain

Dear Editor Abscisic acid （ABA） is the main phytohormone involved in adaptive crop responses to drought. ABA signaling relies on the family of pyrabactin resistance 1/PYRl-like/regulatory components of ABA receptors （PYR/PYL/RCAR）, which upon ABA binding form high-affinity ternary complexes with clade A protein phosphatases type 2C （PP2Cs） and inhibit them （Cutler et al., 2010）. This results in the activation of an SnRK2-dependent phosphorylation cascade affecting a high number of targets in the plant cells, regulating stomatal aper- ture and the expression of stress-responsive genes （Cutler et al., 2010）.

关键词： Structure of Ligand-Bound Intermediates Crop ABA Receptors Highlights PP2C