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Hand Gesture Recognition on a Resource-Limited Interactive Wristband.

Sensors (Basel) 2021 Aug 25;21(17). Epub 2021 Aug 25.

State Key Laboratory of Transducer Technology, Aerospace Information Research Institute, Chinese Academy of Sciences, Beijing 100190, China.

Most of the reported hand gesture recognition algorithms require high computational resources, i.e., fast MCU frequency and significant memory, which are highly inapplicable to the cost-effectiveness of consumer electronics products. Read More

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Pentosan polysulfate sodium prevents functional decline in chikungunya infected mice by modulating growth factor signalling and lymphocyte activation.

PLoS One 2021 7;16(9):e0255125. Epub 2021 Sep 7.

Institute for Glycomics, Griffith University, Southport, Qld, Australia.

Chikungunya virus (CHIKV) is an arthropod-borne virus that causes large outbreaks world-wide leaving millions of people with severe and debilitating arthritis. Interestingly, clinical presentation of CHIKV arthritides have many overlapping features with rheumatoid arthritis including cellular and cytokine pathways that lead to disease development and progression. Currently, there are no specific treatments or vaccines available to treat CHIKV infections therefore advocating the need for the development of novel therapeutic strategies to treat CHIKV rheumatic disease. Read More

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September 2021

Case Report: BAF-Opathies/SSRIDDs Due to a ACTL6A Variant, Previously Considered to Be Heart-Hand Syndrome.

Front Cardiovasc Med 2021 13;8:708033. Epub 2021 Aug 13.

Department of Cardiovascular Surgery, Clinical Center for Gene Diagnosis and Therapy, The Second Xiangya Hospital of Central South University, Changsha, China.

This study aims to identify genetic lesions in patients with congenital heart disease (CHD) with or without other phenotypes. In this study, over 400 patients were recruited and several novel variants in known causative genes were identified. A Chinese patient clinically diagnosed with HHS (patent ductus arteriosus, persistent left superior vena cava, and congenital absence of left arm radius) was included in the study cohort. Read More

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Pilot Safety and Feasibility Study of Non-invasive Limb Proprioceptive Cerebellar Stimulation for Epilepsy.

Front Neurol 2021 17;12:675947. Epub 2021 Aug 17.

Department of Neurology, Olive View Medical Center, University of California, Los Angeles, Los Angeles, CA, United States.

Cerebellar stimulation reduces seizures in animals and in humans with drug-resistant epilepsy. In a pilot safety and feasibility study, we applied continuous cutaneous vibratory stimulation (limb proprioceptive cerebellar stimulation) to foot limb proprioceptive receptors to activate cerebellar, pontine, and thalamic structures in drug-resistant epilepsy patients for 8-h nocturnally up to 6-months after a 4-week pre-treatment control baseline. Seizure frequency was evaluated during the baseline control period, and at 6, 12, and 24 weeks after the control recordings. Read More

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Exercise Therapy Using the Lumbar-Type Hybrid Assistive Limb Ameliorates Locomotive Function after Lumbar Fusion Surgery in an Elderly Patient.

Case Rep Orthop 2021 22;2021:1996509. Epub 2021 Aug 22.

Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan.

The number of elderly people who undergo lumbar fusion surgery (LFS) has been increasing. Postoperative rehabilitation for them can be problematic due to lumbar stiffness. This is the first case report describing exercise therapy using the lumbar-type hybrid assistive limb (HAL) after multiple LFS in an elderly patient. Read More

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Aortic Thrombus Extending to Left Subclavian in a Patient With Diffuse Venous Thromboembolism on Aromatase Inhibitor Therapy.

Cureus 2021 Jul 28;13(7):e16698. Epub 2021 Jul 28.

Internal Medicine, Ocala Regional Medical Center, Ocala, USA.

Concomitant arterial and venous thrombosis is an infrequent event often associated with malignancy, hyperhomocysteinemia, and thrombophilic conditions. Some overlapping pathophysiology mechanisms suggest an association between arterial and venous thrombosis. It is reported that thrombosis in the arterial and venous systems develops through distinct mechanisms affecting inflammatory and oxidative pathways. Read More

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sEMG Activity in Superimposed Vibration on Suspended Supine Bridge and Hamstring Curl.

Front Physiol 2021 11;12:712471. Epub 2021 Aug 11.

Sport and Physical Activity Studies Centre (CEEAF), University of Vic-Central University of Catalonia, Vic, Spain.

Traditionally in strength and conditioning environments, vibration has been transmitted using platforms, barbells, dumbbells, or cables but not suspension devices. This study aimed to examine the effects on the lower limb of applying superimposed vibration on a suspension device. Twenty-one physically active men and women performed supine bridge and hamstring curl exercises in three suspended conditions (non-vibration, vibration at 25 Hz, and vibration at 40 Hz). Read More

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Contemporary Outcomes After Partial Resection Of Infected Aortic Grafts.

Ann Vasc Surg 2021 Aug 23. Epub 2021 Aug 23.

University of Patras, Patras, Greece.

Introduction: Aortic graft infection remains a considerable clinical challenge, and it is unclear which variables are associated with adverse outcomes among patients undergoing partial resection.

Methods: A retrospective, multi-institutional study of patients who underwent partial resection of infected aortic grafts from 2002-2014 was performed using a standard database. Baseline demographics, comorbidities, operative, and postoperative variables were recorded. Read More

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Early and midterm outcomes of hybrid first line treatment in patients with chronic limb threatening ischemia.

Vascular 2021 Aug 20:17085381211040986. Epub 2021 Aug 20.

Department of vascular surgery, University Hospital and Trust of Verona, University of Verona-School of Medicine, Verona, Italy.

Objective: The aim of the study was to evaluate the outcome of first line hybrid treatment in patients with chronic limb threatening ischemia (CLTI) and to evaluate possible predictors of primary patency (PP) loss and limb clinical improvement (LCI).

Methods: This was a retrospective non-randomized study. All patients underwent one-stage hybrid common femoral artery (CFA) endarterectomy combined with an inflow and/or outflow endovascular revascularization procedure. Read More

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Outcomes of Hypogastric Coverage and Occlusion during Endovascular Treatment of Aortoiliac Occlusive Disease.

Ann Vasc Surg 2021 Aug 16. Epub 2021 Aug 16.

Department of Vascular Surgery, Cleveland Clinic, Cleveland, OH. Electronic address:

Background: The risk of hypogastric occlusion (HO) following bare-metal stent (BMS) coverage of the hypogastric origin during endovascular treatment of aortoiliac occlusive disease (AIOD) is unclear. This study sought to determine the rate and clinical significance of HO following BMS coverage during iliac stenting for complex AIOD.

Methods: Consecutive patients undergoing elective iliac stenting for AIOD from 2010-2018 at Cleveland Clinic were reviewed. Read More

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Does Local Zoledronate Applied to Pasteurized Bone Autografts Improve the Likelihood of Union of Graft-host Junctions after Limb-sparing Surgery?

Clin Orthop Relat Res 2021 Aug 18. Epub 2021 Aug 18.

Research Unit, Institute of Orthopaedics, Lerdsin Hospital, Bangkok, Thailand.

Background: Pasteurized bone autograft is a recycling biological reconstruction method for limb-sparing surgery when an allograft or other reconstruction technique is unavailable. Since the application of a local bisphosphonate to morselized allografts can reduce graft resorption and enhance bone formation without systemic complications, adding the local bisphosphonate to pasteurized bone autografts should reduce the graft resorption and improve the graft incorporation to host bone. However, no study that we know of has described the outcomes of local bisphosphonate application to massive allografts or pasteurized bone autografts. Read More

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Endovascular recanalization and remodeling of abdominal aorta stent graft chronic total occlusion after failed extra-anatomic bypass surgery.

Vascular 2021 Aug 18:17085381211040905. Epub 2021 Aug 18.

Department of Radiology, Okan University Hospital, Istanbul, Turkey.

Objectives: Chronic total occlusion (CTO) of the EVAR graft is a rare and serious complication. Traditionally, surgical intervention with prosthetic graft replacement or bypass graft implantation is performed. However, there are limited data in endovascular era. Read More

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Institutional Experience and Orthoplastic Collaboration Associated with Improved Flap-based Limb Salvage Outcomes.

Clin Orthop Relat Res 2021 08 16. Epub 2021 Aug 16.

Department of Surgery, Uniformed Services University-Water Reed National Military Medical Center, Bethesda, MD, USA.

Background: Flap-based limb salvage surgery balances the morbidity and complexity of soft tissue transfer against the potential benefit of preserving a functional limb when faced with a traumatized extremity with composite tissue injury. These composite tissue injuries are well suited for multidisciplinary management between orthopaedic and plastic surgeons. Thus, it makes intuitive sense that a collaborative, orthoplastic approach to flap-based limb salvage surgery can result in improved outcomes with decreased risk of flap failure and other complications, raising the question of whether this orthoplastic team approach should be the new standard of care in limb salvage surgery. Read More

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Limb salvage following snakebite using acute limb shortening and secondary lengthening.

Int J Crit Illn Inj Sci 2021 Apr-Jun;11(2):98-101. Epub 2021 Jun 29.

Department of Burns and Plastic Surgery, AIIMS, Rishikesh, Uttarakhand, India.

A case of 16-year-old boy from the remote tribal population of Uttarakhand is described, who sustained a viper snakebite. The patient after various interventions and referrals developed locoregional and systemic complications. He not only had an open tibiofibular fracture but a large bimalleolar defect over his lower limb. Read More

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Targeting Paretic Propulsion and Walking Speed With a Soft Robotic Exosuit: A Trial.

Front Neurorobot 2021 28;15:689577. Epub 2021 Jul 28.

Paulson School of Engineering and Applied Sciences, Wyss Institute for Biologically Inspired Engineering, Harvard University, Cambridge, MA, United States.

Soft robotic exosuits can facilitate immediate increases in short- and long-distance walking speeds in people with post-stroke hemiparesis. We sought to assess the feasibility and rehabilitative potential of applying propulsion-augmenting exosuits as part of an individualized and progressive training program to retrain faster walking and the underlying propulsive strategy. A 54-yr old male with chronic hemiparesis completed five daily sessions of Robotic Exosuit Augmented Locomotion (REAL) gait training. Read More

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Unusual Endovascular Treatment of Iliac Occlusive Disease With a Physician-Modified Endograft to Preserve a Transplant Renal Artery.

J Endovasc Ther 2021 Aug 8:15266028211036476. Epub 2021 Aug 8.

Department of Vascular Surgery, Santa Chiara Hospital, Trento, Italy.

Purpose: We describe the feasibility and early results of iliac stenting using a physician-modified endograft (PMEG) to preserve a transplant renal artery in patient with iliac occlusive disease.

Case Report: A 70-year-old male patient, with sub-occlusive left common iliac artery stenosis at the level of the transplanted kidney arterial anastomosis, presented with left critical limb ischemia (CLI) and pseudo-transplant renal artery stenosis (pseudo-TRAS) symptoms. He was treated with a physician-modified fenestrated covered stent introduced percutaneously via ipsilateral femoral artery after failure of simple angioplasty (percutaneous transluminal angioplasty, PTA). Read More

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Percutaneous thrombectomy in the management of early rethrombosis in venous thoracic outlet syndrome: two case reports.

CVIR Endovasc 2021 Aug 6;4(1):61. Epub 2021 Aug 6.

Department of Vascular Surgery, University Hospital, Kollárova 2, 036 59, Martin, Slovakia.

Background: Venous thoracic outlet syndrome resulting in the upper limb deep venous thrombosis is known as Paget-Schroetter syndrome or effort thrombosis. A general treatment algorithm includes catheter-directed thrombolysis followed by surgical thoracic outlet decompression. There are limited data regarding endovascular treatment of rethrombosis presenting early after the surgery. Read More

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Effectiveness and safety of a new helmet CPAP configuration allowing tidal volume monitoring in patients with COVID-19.

Pulmonology 2021 Jul 9. Epub 2021 Jul 9.

Fondazione "Giglio", Cefalù, Italy; Department of Surgical, Oncological and Oral Science (Di.Chir.On.S.). University of Palermo, Italy.

Background: High generated tidal volumes (V) have been correlated with higher risk of self-induced lung injury and worse clinical outcome. This study aimed to evaluate the effectiveness and safety of a new helmet continuous positive airway pressure delivered (h-CPAP) configuration allowing V monitoring in patients affected by COVID-19.

Methods: This prospective observational study was performed in the respiratory intermediate care unit of University Hospital in Turin, Italy, between March 24th, and June 15th, 2020. Read More

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The complexities of insulin allergy: a case and approach.

Allergy Asthma Clin Immunol 2021 Jul 29;17(1):79. Epub 2021 Jul 29.

Division of Allergy and Immunology, Department of Medicine, Western University, London, ON, Canada.

Background: Insulin hypersensitivity is rare, but challenging for individuals with diabetes. The prevalence of insulin allergy has decreased since the introduction of human recombinant insulin preparations. Hypersensitivity reactions range from injection site erythema and swelling, to anaphylaxis. Read More

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Acute neurologic decline in a patient with spinal stenosis: blame it on the epidural fat.

Br J Neurosurg 2021 Jul 28:1-6. Epub 2021 Jul 28.

Neurosurgery Unit San Carlo Borromeo Hospital, Milan, Italy.

Spinal epidural lipomatosis [SEL] is defined as an excessive accumulation of extradural normal adipose tissue. This condition may be idiopathic or acquired. Surgical decompression is considered the gold standard treatment in patients presenting with progressive neurologic deficit. Read More

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Large anterior tibial artery pseudoaneurysm as a rare complication to vascular surgery.

J Surg Case Rep 2021 Jul 23;2021(7):rjab303. Epub 2021 Jul 23.

Department of Vascular Surgery, Roskilde University Hospital, Roskilde, Denmark.

A pseudoaneurysm is a rare complication to vascular reconstruction and may be limb threatening if not treated. A patient previously treated for an aneurysm of the left popliteal artery presented to our outpatient clinic with swelling and reduced active movement. Computed Tomography Angiography revealed an 8. Read More

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IDEO energy-storing orthosis: Effects on lower extremity function and preservation.

Injury 2021 Jul 18. Epub 2021 Jul 18.

USU-WRNMMC Department of Surgery, Bethesda, MD, United States.

Introduction: The Intrepid Dynamic Exoskeletal Orthosis (IDEO) brace is a custom energy-storing orthosis design meant to improve gait, stability, and function after lower extremity injury or limb salvage. Early studies demonstrated the potential for the IDEO to improve functional performance, in conjunction with its paired return to run (RTR) rehabilitation program, compared to other brace types, and an impressively decreased rate of late amputation. The current study aimed to investigate these functional and revision outcomes from our institution to determine which patients may benefit most from IDEO bracing and what factors of the IDEO design and rehabilitation program are most important for improved outcomes after lower extremity trauma and/or loss of function. Read More

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Inferior Vena Cava Syndrome as a Manifestation of Metastatic Carcinoid Tumor.

Gastrointest Tumors 2021 Jun 13;8(3):138-143. Epub 2021 Apr 13.

Department of Interventional Radiology, UF Health Jacksonville, University of Florida, Jacksonville, Florida, USA.

Small bowel-origin carcinoid tumor is indolent but may metastasize relentlessly to various sites, including the liver. Over the past 9 years, we have treated a 69-year-old woman who has undergone 5 percutaneous liver ablations, 5 hepatic intra-arterial chemoembolizations, an ovarian cryoablation, and a trans-ventral hernia mesenteric cryoablation. These interventions are all related to her inoperable carcinoid malignancy. Read More

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Systematic Isolation of Key Parameters for Estimating Skeletal Maturity on AP Hip Radiographs.

J Pediatr Orthop 2021 Sep;41(8):483-489

Department of Orthopaedics, University Hospitals Cleveland Medical Center.

Background: The ability to estimate skeletal maturity using a hip radiograph does not yet exist, but may have utility in the treatment of scoliosis, slipped capital femoral epiphysis, and lower limb deformity. We sought to develop a fast, accurate, and reproducible method.

Methods: Fourteen hip radiologic parameters were evaluated on serial anteroposterior hip radiographs from 3 years before to 2 years after the skeletal age associated with 90% of final height, a validated skeletal maturity definition which correlates with the timing of peak height velocity. Read More

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September 2021

Direct puncture of an occluded common femoral artery as a new approach for endovascular aortic aneurysm repair.

CVIR Endovasc 2021 Jul 10;4(1):58. Epub 2021 Jul 10.

Department of Cardiovascular Surgery, Kyoto Okamoto Memorial Hospital, 100 Nishinokuchi, Kumiyama, Kuse District, Kyoto, 613-0034, Japan.

Background: Abdominal aortic aneurysms (AAA) which present with a hostile access are not uncommon. When an arterial occlusion continuously involves from the iliac to the femoropopliteal artery, endovascular aneurysm repair (EVAR) can become complex, necessitating an adjunctive surgical procedure. The present report outlines a successful EVAR which was conducted without any adjunctive surgical procedure for an AAA complicated by extensive access vessel occlusion. Read More

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Hypoimmune induced pluripotent stem cell-derived cell therapeutics treat cardiovascular and pulmonary diseases in immunocompetent allogeneic mice.

Proc Natl Acad Sci U S A 2021 Jul;118(28)

Division of Cardiothoracic Surgery, Department of Surgery, Transplant and Stem Cell Immunobiology Laboratory, University of California, San Francisco, CA 94143;

The emerging field of regenerative cell therapy is still limited by the few cell types that can reliably be differentiated from pluripotent stem cells and by the immune hurdle of commercially scalable allogeneic cell therapeutics. Here, we show that gene-edited, immune-evasive cell grafts can survive and successfully treat diseases in immunocompetent, fully allogeneic recipients. Transplanted endothelial cells improved perfusion and increased the likelihood of limb preservation in mice with critical limb ischemia. Read More

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Anterior Cruciate Ligament Loading Increases With Pivot-Shift Mechanism During Asymmetrical Drop Vertical Jump in Female Athletes.

Orthop J Sports Med 2021 Mar 9;9(3):2325967121989095. Epub 2021 Mar 9.

Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA.

Background: Frontal plane trunk lean with a side-to-side difference in lower extremity kinematics during landing increases unilateral knee abduction moment and consequently anterior cruciate ligament (ACL) injury risk. However, the biomechanical features of landing with higher ACL loading are still unknown. Validated musculoskeletal modeling offers the potential to quantify ACL strain and force during a landing task. Read More

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COVID-19 diagnosis in a patient with critical limb ischemia: complications and clinical outcomes.

J Vasc Bras 2020 Sep 21;19:e20200071. Epub 2020 Sep 21.

Hospital Regional Sul, Serviço de Cirurgia Vascular e Endovascular, São Paulo, SP, Brasil.

A 67-year-old male diabetic patient with systemic arterial hypertension was admitted to the emergency department with a necrotic ulcer in the left external malleolus and no palpable popliteal or pedal pulses. Arterial Duplex ultrasound identified femoropopliteal occlusion, with popliteal refilling below the knee and a patent peroneal artery. An endovascular procedure was performed, requiring retrograde access to the popliteal artery to re-establish blood flow and deploy a popliteal stent. Read More

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September 2020

Hybrid Assistive Limb Functional Treatment for a Patient with Chronic Incomplete Cervical Spinal Cord Injury.

Int Med Case Rep J 2021 21;14:413-420. Epub 2021 Jun 21.

Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.

Introduction: The hybrid assistive limb (HAL) is a wearable exoskeleton cyborg that assists walking and lower limb movements via real-time actuator control by detecting the wearer's bioelectric signals on the surface of their skin.

Purpose: The purpose of this study was to report the improvement in walking ability following HAL gait training in a patient with tetraplegia after incomplete cervical spinal cord injury (SCI).

Patient And Methods: A 47-year-old man with traumatic cervical SCI for six months after fall had incomplete tetraplegic SCI grade C as classified according to the American Spinal Cord Injury Association impairment scale and was unable to walk in conventional rehabilitation. Read More

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Military Service Members with Major Lower Extremity Fractures Return to Running with a Passive-dynamic Ankle-foot Orthosis: Comparison with a Normative Population.

Clin Orthop Relat Res 2021 Jun 24. Epub 2021 Jun 24.

Department of Orthopedic Surgery, Scripps Mercy Hospital, San Diego, CA, USA.

Background: Lower extremity fractures represent a high percentage of reported injuries in the United States military and can devastate a service member's career. A passive dynamic ankle-foot orthosis (PD-AFO) with a specialized rehabilitation program was initially designed to treat military service members after complex battlefield lower extremity injuries, returning a select group of motivated individuals back to running. For high-demand users of the PD-AFO, the spatiotemporal gait parameters, agility, and quality of life is not fully understood with respect to uninjured runners. Read More

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