Some companies have launched telepresence robots with applications in education, management, conferences and workshops. Robots available in commerce are somewhat simple, with just one tablet, a ...smartphone, or a computer at the user. The robot itself is made up of a robot car, a telescope bar, a display (tablet, smartphone, or dedicated crystal display), software and it makes a realistic remote communication that enable the user to interact effectively with the remote environment. A challenge in the field of research and design of telepresence robots is the realization of humanoid robots that allow the human user to connect to the robot through wireless technologies and with sensors to take on environmental sensations and interact with the environment where the robot is. Until such robots become available to the general public, several steps should be taken: solving the balance problems and digital control of the current humanoid robots, customizing the public with robotic humanoid applications, studying the interaction between people and telepresence robots and using the data obtained in the design of robots. In the educational system, telepresence robots can make possible the virtual participation of the students with disabilities, that can't be transported to school, to the class for taking part at the courses. Also, telepresence robots can be used for multimedia educational projects which involves filming and taking photos in dangerous areas for humans such as: caves, small spaces or areas with radiation. The problem of the commercial telepresence robots, to be used in education, consists in two elements: they have big dimensions, weight (not easy to carry for kids) and are expensive. In this paper we present three projects as alternatives to commercial telepresence robots. The first two are based on commercial educational kits that are easy to mount, have software installed, but are less flexible for applications dedicated to telepresence robotics. The third project is made with open source components that offer a lot of flexibility at a low price and allows the implementation in the software of the desired mathematical model. We also have analyzed, in this paper, the interaction of secondary and high school students with the telepresence robots, so we have find some future directions of research like: intelligent autonomy dedicated software, a commercial design and the possibility to be easily personalized for each user or class of students.
The teleostean Channichthyidae (icefish), endemic stenotherms of the Antarctic waters, perennially at or near freezing, represent a unique example of disaptation among adult vertebrates for their ...loss of functional traits, particularly hemoglobin (Hb) and, in some species, cardiac myoglobin (Mb), once considered to be essential-life oxygen-binding chromoproteins. Conceivably, this stably frigid, oxygen-rich habitat has permitted high tolerance of disaptation, followed by subsequent adaptive recovery based on gene expression reprogramming and compensatory responses, including an alternative cardio-circulatory design, Hb-free blood and Mb-free cardiac muscle. This review revisits the functional significance of the multilevel cardio-circulatory compensations (hypervolemia, near-zero hematocrit and low blood viscosity, large bore capillaries, increased vascularity with great capacitance, cardiomegaly with very large cardiac output, high blood flow with low systemic pressure and systemic resistance) that counteract the challenge of hypoxemic hypoxia by increasing peripheral oxygen transcellular movement for aerobic tissues, including the myocardium. Reconsidered in the context of recent knowledge on both polar cold adaptation and the new questions related to the advent of nitric oxide (NO) biology, these compensations can be interpreted either according to the “loss-without-penalty” alternative, or in the context of an excessive environmental oxygen supply at low cellular cost and oxygen requirement in the cold. Therefore, rather than reflecting oxygen limitation, several traits may indicate structural overcompensation of oxygen supply reductions at cell/tissue levels. At the multilevel cardio-circulatory adjustments, NO is revealing itself as a major integrator, compensating disaptation with functional phenotypic plasticity, as illustrated by the heart paradigm. Beside NOS-dependent NO generation, recent knowledge concerning Hb/Mb interplay with NO and nitrite has revealed unexpected functions in addition to the classical respiratory role of these proteins. In fact, nitrite, a major biologic reservoir of NO, generates it through deohyHb- and deoxyMb-dependent nitrite reduction, thereby regulating hypoxic vasodilation, cellular respiration and signalling. We suggest that both Hb and Mb are involved as nitrite reductases under hypoxic conditions in a number of cardiocirculatory processes. On the whole, this opens new horizons in environmental and evolutionary physiology.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, PNG, SAZU, SBCE, SBJE, UL, UM, UPUK
PURPOSE: Sub-Tenon anesthesia is a form of local anesthetic techniques used in ophthalmic procedures, especially in cataract surgery. Few studies in our environment have reported the effects of ...sub-Tenon anesthesia on akinesia and analgesia as well as optimum volumes of anesthetic agents that are required for effective analgesia and akinesia. The objective of this study is to determine and compare the level of analgesia and akinesia and the effect of ocular compressions after sub-Tenon injection of 2 mL versus 3 mL of xylocaine among patients booked for cataract surgery in the University of Ilorin Teaching Hospital (UITH). METHODS: A cross-sectional comparative study among cataract patients booked for surgery in the Department of Ophthalmology at UITH was carried out from March 2017 to August 2017. A total of 200 cataract patients that met the inclusion criteria were recruited into the study over 6 months. Lists of cataract patients booked for surgery formed the sampling frame. Questionnaires were administered to obtain information on sociodemographic, ocular symptoms, and other histories. Visual acuity was checked, and ocular examination was done with a pen-torch, ophthalmoscope, and slit-lamp examination with 78D. Tonometry and optic nerve assessments were done to exclude any patient with preexisting glaucoma or suspicious disc. About 200 patients were randomly allocated into one of two volume groups (Group 1 had 2 mL sub-Tenon xylocaine injection whereas Group 2 had 3 mL); level of analgesia and akinesia was checked 12 min and 15 min, respectively. RESULTS: The age range was 20–107 years; mean age for Group 1 was 63.8 ± 12.64, whereas the mean age of Group 2 was 64.14 ± 14.14. There was a slight female preponderance given a M:f of 1:1.4 and more than half of the patients presented with right eye (RE) cataract. Levels of analgesia 12 min after sub-Tenon injections in both groups were similar. However, two patients were found to have severe pain in Group 1, and no patients had severe pain in Group 2. The level of akinesia which was assessed 15 min after injection in both groups was found to be significantly better in Group 2. CONCLUSION: There was a slight female preponderance with about two-third of the total patients being female and the percentage of females who had no pain was more than the male, more than 50% of the patients had RE cataracts. Sub-Tenon anesthesia whether with 2 mL or 3 mL led to a statistically significant rise in intraorbital pressure (IOP); however, with ocular compression, the IOP was found to decrease below the preinjection pressure in both groups. Levels of analgesia were similar in the two groups, whereas akinesia was statistically better in the group that had 3 mL injection.
Background: Corneal ulceration is one of the major causes of avoidable blindness and visual impairment globally. Objectives: The aim of this study was to analyze clinical and demographic data of ...corneal ulcers at the Department of Ophthalmology, University of Ilorin Teaching Hospital (UITH), Ilorin, Kwara state between 2017 and 2021. Methods: A retrospective survey of all cases of corneal ulcer under review period was done. Demographic and clinical data were retrieved from hospital records and analyzed using Statistical Package for Social Sciences (SPSS) version 20. Results: A total of 92 cases were reviewed, consisting of 66 males, majority (76.1%) are married, and traders and artisan accounted for 54.3%. The age ranges from 6 months to 78 years with 41.2 years as average. The major identified risk factors were trauma (16.3%) and harmful traditional medications (13%). Visual acuity (VA) in 82.6% of the patients at presentation was <3/60 to no perception of light (NPL), while 10.9% presented with VA of 6/6 to 6/18. The most dominant causes of corneal ulcers were microbial keratitis (72.8%) and hypopyon keratitis (12.5%). Time of onset to presentation was within 1 week in 33 patients (35.9%), 29 patients (31.5%) after a week, while others presented over a month. After treatment, VA was 69.5% (<3/60-NPL), 21.7% (6/6-6/18), and 8.7% (6/18-3/60). Five patients had evisceration, two out of which were auto-evisceration. Conclusion: Ocular trauma was the most common risk factor with microbial keratitis as the most dominant cause. Poor treatment outcome resulted from late presentation, use of herbal, self and over-the-counter medications. Appropriate health promotion activities need to be conducted to address the identified risk factors at all levels of care.
The Frank–Starling law is a fundamental property of the vertebrate myocardium which allows, when the end-diastolic volume increases, that the consequent stretch of the myocardial fibers generates a ...more forceful contraction. It has been shown that in the eel (Anguilla anguilla) heart, nitric oxide (NO) exerts a direct myocardial relaxant effect, increasing the sensitivity of the Frank–Starling response (Garofalo et al., 2009). With the use of isolated working heart preparations, this study investigated the relationship between NO modulation of Frank–Starling response and temperature challenges in the eel. The results showed that while, in long-term acclimated fish (spring animals perfused at 20°C and winter animals perfused at 10°C) the inhibition of NO production by L-N5 (1-iminoethyl)ornithine (L-NIO) significantly reduced the Frank–Starling response, under thermal shock conditions (spring animals perfused at 10 or 15°C and winter animals perfused at 15 or 20°C) L-NIO treatment resulted without effect. Western blotting analysis revealed a decrease of peNOS and pAkt expressions in samples subjected to thermal shock. Moreover, an increase in Hsp90 protein levels was observed under heat thermal stress. Together, these data suggest that the NO synthase/NO-dependent modulation of the Frank–Starling mechanism in fish is sensitive to thermal stress.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, PNG, SAZU, SBCE, SBJE, UL, UM, UPUK
The HeartLogic algorithm combines multiple implantable cardioverter-defibrillator sensors to identify patients at risk of heart failure (HF) events. We sought to evaluate the risk stratification ...ability of this algorithm in clinical practice. We also analyzed the alert management strategies adopted in the study group and their association with the occurrence of HF events.
The HeartLogic feature was activated in 366 implantable cardioverter-defibrillator and cardiac resynchronization therapy implantable cardioverter-defibrillator patients at 22 centers. The median follow-up was 11 months 25th-75th percentile: 6-16. The HeartLogic algorithm calculates a daily HF index and identifies periods IN alert state on the basis of a configurable threshold.
The HeartLogic index crossed the threshold value 273 times (0.76 alerts/patient-year) in 150 patients. The time IN alert state was 11% of the total observation period. Patients experienced 36 HF hospitalizations, and 8 patients died of HF during the observation period. Thirty-five events were associated with the IN alert state (0.92 events/patient-year versus 0.03 events/patient-year in the OUT of alert state). The hazard ratio in the IN/OUT of alert state comparison was (hazard ratio, 24.53 95% CI, 8.55-70.38,
<0.001), after adjustment for baseline clinical confounders. Alerts followed by clinical actions were associated with less HF events (hazard ratio, 0.37 95% CI, 0.14-0.99,
=0.047). No differences in event rates were observed between in-office and remote alert management.
This multiparametric algorithm identifies patients during periods of significantly increased risk of HF events. The rate of HF events seemed lower when clinical actions were undertaken in response to alerts. Extra in-office visits did not seem to be required to effectively manage HeartLogic alerts. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT02275637.
Aims
To assess adherence to guideline recommendations among a large network of Italian cardiology sites in the management of acute and chronic heart failure (HF) and to evaluate if an ad‐hoc ...educational intervention can improve their performance on several pharmacological and non‐pharmacological indicators.
Methods and results
BLITZ‐HF was a cross‐sectional study based on a web‐based recording system with pop‐up reminders on guideline recommendations used during two 3‐month enrolment periods carried out 3 months apart (Phase 1 and 3), interspersed by face‐to‐face macro‐regional benchmark analyses and educational meetings (Phase 2). Overall, 7218 patients with acute and chronic HF were enrolled at 106 cardiology sites. During the enrolment phases, 3920 and 3298 patients were included, respectively, 84% with chronic HF and 16% with acute HF in Phase 1, and 74% with chronic HF and 26% with acute HF in Phase 3. At baseline, adherence to guideline recommendations was already overall high for most indicators. Among acute HF patients, an improvement was obtained in three out of eight indicators, with a significant rise in echocardiographic evaluation. Among chronic HF patients with HF and preserved or mid‐range ejection fraction, performance increased in two out of three indicators: creatinine and echocardiographic evaluations. An overall performance improvement was observed in six out of nine indicators in ambulatory HF with reduced ejection fraction patients with a significant increase in angiotensin receptor–neprilysin inhibitor prescription rates.
Conclusions
Within a context of an already elevated level of adherence to HF guideline recommendations, a structured multifaceted educational intervention could be useful to improve performance on specific indicators. Extending this approach to other non‐cardiology healthcare professionals, who usually manage patients with HF, should be considered.
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BFBNIB, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, UL, UM, UPUK
•Lungfish is a model of organ morpho-functional adaptation to environmental challenge.•During aestivation lungfish gills stop working whereas lungs enhance their function.•No available data on ...molecular signaling involved in lungfish respiratory adaptation.•First evidence on NOS, Akt, Hsp-90, HIF-1α signaling in lungfish gills and lungs.
African lungfishes are obligate air breathers, with reduced gills and pulmonary breathing throughout their life. During the dry season they aestivate on land, with the collapse of secondary lamellae of their gills and the establishment of an exclusive aerial ventilation through the vascularization and expansion of their lungs. To date, the mechanisms underlining the respiratory organ remodeling in aestivating lungfishes are unknown. This study aimed to identify key switch components of the stress-induced signal transduction networks implicated in both rapid and medium–long term remodeling of the gills and lungs of the African lungfish Protopterus annectens during aestivation. Through immunofluorescence microscopy and Western blotting, the localization and the expression of nitric oxide synthase (NOS), Akt, Hsp-90 and HIF-1α were evaluated in both gills and lungs exposed to three experimental conditions: freshwater (FW), 6 months of experimentally induced aestivation (6mAe), and 6 days after arousal from 6 months of aestivation (6mAe6d). After 6mAe, the expression of NOS (p-eNOS antibody), Akt (p-Akt antibody), and Hsp-90 decreased in the gills, while NOS and Hsp-90 expression increased with Akt remained unchanged in the lungs. Upon 6mAe6d, NOS, Akt and Hsp-90 expression in the gills returned to the respective FW values. In the lungs of the aroused fish, NOS and Akt decreased to their respective FW levels, while Hsp-90 expression was enhanced with respect to aestivation. In both respiratory organs, the qualitative and quantitative patterns of HIF-1α expression correlated inversely to those of NOS. Overall, our findings suggest that the molecular components of the NOS/NO system changed in a tissue-specific manner in parallel with organ readjustment in the gills and lungs of P. annectens during aestivation and arousal.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Most acute promyelocytic leukemia (APL) patients express PML-RARA fusion; in rare cases, RARA is rearranged with partner genes other than PML. To date, only 2 patients presenting features similar to ...APL showing the RARG gene rearrangement have been described. We report an acute myeloid leukemia patient with morphology resembling APL without involvement of the RARA gene. Molecular and fluorescent in situ hybridization analyses excluded PML-RARA fusion and variant rearrangements involving RARA and RARG loci. Targeted next-generation sequencing showed EZH2- D185H mutation. As this mutation involved the region of interaction with DNA methyltransferases, we speculate an epigenetic alteration of genes involved in the APL-like phenotype. Expression analysis by droplet digital polymerase chain reaction revealed downregulation of the RARA and RARG genes. We hypothesize a novel mechanism of EZH2 function alteration, which may be responsible for an acute myeloid leukemia with APL-like phenotype featuring dysregulation of the RARA and RARG genes.
•Rare AML cases with an APL-like morphology have been reported.•APL-like leukemia showed no PML-RARA fusion but MYC amplification or cytogenetic abnormalities.•EZH2 alteration associated with RAR genes dysregulation may bring the APL-like morphology in AML.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
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