Mejiakrause9669

27% of therapists reported that they were interested in using Lil'Flo. Therapists interested in using Lil'Flo perceived it as having significantly higher usefulness across all measured dimensions than those who were not interested in using it.In this letter, we propose a novel constant-force end-effector (CFEE) to address current limitations in robotic ultrasonography. The CFEE uses a parallel, motor-spring-based solution to precisely generate constant operating forces over a wide range and enable the ultrasound (US) probe to adapt to the abdominal contours autonomously. A displacement measurement unit was developed to realize the acquisition of probe position and precise control of the operating force. Moreover, the operating force can be adjusted online to maintain safety and continuity of operation. Simulations and experiments were carried out to evaluate the performance. Results show that the proposed CFEE can provide constant forces of 4-12 N with displacements of 0-8 mm. The maximum relative error of force generation is 8.28%, and the accuracy and precision for displacement measurement are 0.29 mm and ±0.16 mm, respectively. Various operating forces can be adjusted online during the same operation. Ultrasound images acquired by the proposed CFEE are of equally good quality compared to a manual sonographer scan. The proposed CFEE would have potential further medical applications.Lower-limb exoskeletons are widely researched to improve walking performance and mobility. Low-level sensor-less exoskeleton motor control is attractive for consumer applications due to reduced device complexity and cost, but complex and variable transmission system configurations make the development of effective open-loop motor controllers that are responsive to user input challenging. The objective of this study was to develop and validate an open-loop motor control framework resulting in similar or greater performance vs. closed-loop torque control. We used generalized linear regression to develop two open-loop controllers by modeling motor current during exoskeleton-assisted walking; a "complex" model used desired torque and estimated ankle angular velocity as inputs, while a "simple" model used desired torque alone. Five participants walked at 1.0-1.3 m/s on a treadmill with closed-loop and both open-loop controllers providing ankle exoskeleton assistance. Both open-loop current controllers had similar root-mean-squared torque tracking error (p=0.23) compared to the closed-loop torque-feedback controller. Both open-loop controllers had improved relative average torque production (p less then 0.001 complex, p=0.022 simple), lower power consumption (p less then 0.001 for both), and reduced operating noise (p=0.002 complex, p less then 0.001 simple) over the closed-loop controller. New control models developed for a different ankle exoskeleton configuration showed similar improvements (lower torque error, greater average and peak torque production, lower power consumption) over closed-loop control during over-ground walking. These results demonstrate that our framework can produce open-loop motor controllers that match closed-loop control performance during exoskeleton operation.This paper reports the improved design, system integration, and initial experimental evaluation of a fully actuated body-mounted robotic system for real-time MRI-guided lower back pain injections. selleck kinase inhibitor The 6-DOF robot is composed of a 4-DOF needle alignment module and a 2-DOF remotely actuated needle driver module, which together provide a fully actuated manipulator that can operate inside the scanner bore during imaging. The system minimizes the need to move the patient in and out of the scanner during a procedure, and thus may shorten the procedure time and streamline the clinical workflow. The robot is devised with a compact and lightweight structure that can be attached directly to the patient's lower back via straps. This approach minimizes the effect of patient motion by allowing the robot to move with the patient. The robot is integrated with an image-based surgical planning module. A dedicated clinical workflow is proposed for robot-assisted lower back pain injections under real-time MRI guidance. Targeting accuracy of the system was evaluated with a real-time MRI-guided phantom study, demonstrating the mean absolute errors (MAE) of the tip position to be 1.50±0.68mm and of the needle angle to be 1.56±0.93°. An initial cadaver study was performed to validate the feasibility of the clinical workflow, indicating the maximum error of the position to be less than 1.90mm and of the angle to be less than 3.14°.For most patients with kidney failure, living donor kidney transplant (LDKT) is their best treatment option. Compared with White people, Black people are more likely to have kidney failure but less likely to receive LDKTs. In this study, the investigators will test an educational intervention, Destination Transplant, designed to reduce this disparity, among Black people already listed for kidney transplant.

The investigators will conduct a parallel group, 2-arm randomized clinical trial among 500 Black kidney transplant candidates. link2 The main objective of this study is to test an educational and behavioral intervention that is designed to increase receipt of LDKT among transplant candidates (persons active on the deceased donor kidney transplant waiting list) who are Black. Candidates on the kidney transplant waiting list will be randomly assigned to 1 of 2 conditions (1) a control group that will receive Usual Care, or (2) an Intervention group that will receive Destination Transplant, a 9-month intervention g Black and African American patients who are already on the kidney transplant waiting list. The aim of the intervention is to reduce racial disparities in access to LDKT.The onset of brain death (BD) leads to the deterioration of potential donor lungs. Methylprednisolone is considered to increase lung oxygenation capacity and enhance the procurement yield of donor lungs, when applied in situ, during donor management. However, whether BD-induced lung damage is ameliorated upon treatment with methylprednisolone during acellular ex vivo lung perfusion (EVLP), remains unknown. We aimed to investigate whether the quality of lungs from brain-dead donors improves upon methylprednisolone treatment during EVLP.

Rat lungs were randomly assigned to 1 of 3 experimental groups (n = 8/group) (1) healthy, directly procured lungs subjected to EVLP; (2) lungs from brain-dead rats subjected to cold storage and EVLP; and (3) lungs from brain-dead rats subjected to cold storage and EVLP with 40 mg methylprednisolone added to the perfusate. Ventilation and perfusion parameters, histology, edema formation, metabolic profile, and inflammatory status of lungs were investigated.

Methylprednisoloneone treatment during EVLP attenuates BD-induced lung injury.

We showed that methylprednisolone treatment during EVLP attenuates BD-induced lung injury.Chronic lung allograft dysfunction (CLAD) is the major factor limiting survival post lung transplantation (LTx) with limited effective therapeutic options. link3 We report our 12-y experience of antithymocyte globulin (ATG) as second-line CLAD therapy.

Clinical and lung function data were collected on LTx patients receiving ATG. Rate of FEV1 decline (mL/d) was calculated before and after ATG. Partial response to ATG was defined by rate of FEV1 decline improving 20%. Complete response was defined by an absolute improvement or stability in baseline FEV1.

Seventy-six patients received ATG for CLAD. Of these, 5 patients who had a clinical diagnosis of antibody-mediated rejection and were treated with plasmapheresis before or after ATG were excluded from analysis. Sixteen (23%) were complete responders, 29 (40%) were partial responders, and 26 (37%) did not respond. Those with CLAD stage 2 or 3 and younger age were more likely to respond. Partial responders had a 65% lower risk of death or retransplant (HR, 0.35;

 = 0.003), whereas complete responders reduced their risk by 70% (HR, 0.30;

 = 0.006).

ATG appears to stabilize or attenuate lung function decline in CLAD, which may lead to improved retransplant-free survival. Although certain predictors of response have been identified in this large single-center review, these findings need to be confirmed by a multicenter randomized-controlled trial to determine predictors of response to ATG for CLAD.

ATG appears to stabilize or attenuate lung function decline in CLAD, which may lead to improved retransplant-free survival. Although certain predictors of response have been identified in this large single-center review, these findings need to be confirmed by a multicenter randomized-controlled trial to determine predictors of response to ATG for CLAD.Data supporting the use of carfilzomib (CFZ) for treatment of antibody-mediated rejection (AMR) in lung transplantation in combination with plasmapheresis and intravenous immunoglobulin suggest positive outcomes through donor-specific antibody (DSA) depletion or conversion to noncomplement-activating antibodies. Herein, we describe our center's experience treating AMR with CFZ.

All patients treated with CFZ for AMR from 2014 to 2019 were included. The primary outcome was a positive response to CFZ was defined as (1) loss of DSA C1q-fixing ability after last CFZ dose; (2) clearance of de novo DSA; or (3) decrease in de novo DSA mean fluorescence intensity of >3000.

Twenty-eight patients with 31 AMR episodes were treated with CFZ. A positive response was observed in 74.4% of AMR episodes and 82.1% of patients. This response was driven by loss of complement 1q fixation (70.6%), elimination of class I DSAs (78.6%), and reduction in both classes I (median 2815, 79.5% reduction from baseline) and II DSA mean fluorescence intensity (3171, 37.1%).

CFZ shows potential for ameliorating AMR; however, additional studies are needed to define optimal time of administration.

CFZ shows potential for ameliorating AMR; however, additional studies are needed to define optimal time of administration.

Understanding how perceived positive consequences are associated with drinking may help improve effectiveness of alcohol reduction interventions among people living with HIV (PLWH). We aimed to determine whether perceived positive consequence scores varied by sociodemographic, drinking, mental health or substance use variables.

Perceived positive consequences of drinking were assessed using the PROMIS Positive Consequences-Short Form. Unhealthy alcohol use was measured using a modified AUDIT-C. We used multiple linear regression to identify factors associated with perceived positive consequence.

328 PLWH who consumed at least one alcoholic beverage in the last 6 months participated in the Florida Cohort study (mean age=46, 69% male, 58% Black). Perceived positive consequence scores ranged from 0 to 28 (mean=16.1, SD=6.9). Perceived positive consequence scores increased by 0.8 points for each 1-point increase in AUDIT-C score. Demographics, thoughts on reducing alcohol use, other substance use, depression, and anxiety were not significantly associated with perceived positive consequences.

Our findings suggest perceived positive consequences are associated with unhealthy alcohol use. Positive consequences should be considered with negative consequences in a decisional balance when intervening on alcohol use among PLWH.

Our findings suggest perceived positive consequences are associated with unhealthy alcohol use. Positive consequences should be considered with negative consequences in a decisional balance when intervening on alcohol use among PLWH.