A Socially Assistive Robot for Long-Term Cardiac Rehabilitation in the Real World

What are the benefits of using a socially assistive robot for long-term cardiac rehabilitation? To answer this question we designed and conducted a real-world long-term study, in collaboration with medical specialists, at the Fundación Cardioinfantil-Instituto de Cardiología clinic (Bogotá, Colombia) lasting 2.5 years. The study took place within the context of the outpatient phase of patients' cardiac rehabilitation programme and aimed to compare the patients' progress and adherence in the conventional cardiac rehabilitation programme (control condition) against rehabilitation supported by a fully autonomous socially assistive robot which continuously monitored the patients during exercise to provide immediate feedback and motivation based on sensory measures (robot condition). The explicit aim of the social robot is to improve patient motivation and increase adherence to the programme to ensure a complete recovery. We recruited 15 patients per condition. The cardiac rehabilitation programme was designed to last 36 sessions (18 weeks) per patient. The findings suggest that robot increases adherence (by 13.3%) and leads to faster completion of the programme. In addition, the patients assisted by the robot had more rapid improvement in their recovery heart rate, better physical activity performance and a higher improvement in cardiovascular functioning, which indicate a successful cardiac rehabilitation programme performance. Moreover, the medical staff and the patients acknowledged that the robot improved the patient motivation and adherence to the programme, supporting its potential in addressing the major challenges in rehabilitation programmes.

Effect of patient characteristics on reported outcomes after total knee replacement

OBJECTIVE

To evaluate the effect of pre-intervention factors in patient-reported outcomes at 6 months post-operatively following total knee replacement.

METHODS

A prospective observational study was carried out using two questionnaires sent to patients while they were on the waiting list for surgery: a generic questionnaire, the Medical Outcomes Study Short Form-36 (SF-36), and a specific questionnaire, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Six months after intervention, patients again received the same questionnaires. The dependent variables were the scores of the three domains of the WOMAC and the eight domains of the SF-36.

RESULTS

We recruited 640 patients. The mean age was 71 yrs and 73.6% of the patients were females. The multivariate analysis, in which the pre-intervention scores for each domain were added as covariates, showed that the most significant pre-intervention predictors were the baseline scores of each domain. Besides that, the social support, low back pain and the baseline score of the mental health domain (SF-36) were the pre-intervention predictors in the three WOMAC domains. With regard to the SF-36 domains the main predictors were the baseline mental health score, comorbidities, low back pain and social support.

CONCLUSIONS

The main predictor of outcome at 6 months post-operatively in all eleven domains was the pre-intervention score of each domain. Presence of social support, absence of low back pain and higher baseline SF-36 mental health score were related to the improvement in the health-related quality of life post-operatively.

Genetic and antigenic diversity among eastern equine encephalitis viruses from North, Central, and South America

Eastern equine encephalitis virus (EEEV), the sole species in the EEE antigenic complex, is divided into North and South American antigenic varieties based on hemagglutination inhibition tests. Here we describe serologic and phylogenetic analyses of representatives of these varieties, spanning the entire temporal and geographic range available. Nucleotide sequencing and phylogenetic analyses revealed additional genetic diversity within the South American variety; 3 major South/Central American lineages were identified including one represented by a single isolate from eastern Brazil, and 2 lineages with more widespread distributions in Central and South America. All North American isolates comprised a single, highly conserved lineage with strains grouped by the time of isolation and to some extent by location. An EEEV strain isolated during a 1996 equine outbreak in Tamaulipas State, Mexico was closely related to recent Texas isolates, suggesting southward EEEV transportation beyond the presumed enzootic range. Plaque reduction neutralization tests with representatives from the 4 major lineages indicated that each represents a distinct antigenic subtype. A taxonomic revision of the EEE complex is proposed.

Population genetics in the American Tropics : 18. The genetic structure of peripheral Drosophila pseudoobscura from Colombia

There are several Colombian populations of Drosophila pseudoobscura which have begun to show divergence. The temporal samples of Torobarroso, one of the local populations identified, demonstrate genetic "resourcefulness" and selective opportunism by fluctuating mortality. The data suggest that both balanced selection and mutational origin are necessary to account for the frequencies of drastic genes encountered. In genetic isolates there seems to exist alternatively a mutational component and a balanced - selection component. These components overcome the damage in the first instance and in the second instance, profit from the recessive load.

Diuretic agents and glucose reabsorption

Acetazolamide, chlorothiazide, ethacrynic acid and furosemide were infused to glucose loaded dogs. Glucose reasorption was unchanged after acetazolamide and chlorothiazide. Ethacrynic acid depressed glucose reabsorption significantly. Furosemide caused a modest decrease in glucose reabsorption which was not significant when the control values were compared with the last three experimental values, but which was significant when all experimental values are analyzed. These diuretics most likely depress glucose reabsorption by acting on the proximal tubule, though a distal effect cannot be excluded.