Hubert Roth

Nutritional habits can have a significant impact on cardiovascular health and disease. This may also apply to cardiotoxicity caused as a frequent side effect of chemotherapeutic drugs, such as doxorubicin (DXR). The aim of this work was to analyze if diet, in particular creatine (Cr) supplementation, can modulate cardiac biochemical (energy status, oxidative damage and antioxidant capacity, DNA integrity, cell signaling) and functional parameters at baseline and upon DXR treatment. Here, male Wistar rats were fed for 4 weeks with either standard rodent diet (NORMAL), soy-based diet (SOY), or Cr-supplemented soy-based diet (SOY + Cr). Hearts were either freeze-clamped in situ or following ex vivo Langendorff perfusion without or with 25 μM DXR and after recording cardiac function. The diets had distinct cardiac effects. Soy-based diet (SOY vs. NORMAL) did not alter cardiac performance but increased phosphorylation of acetyl-CoA carboxylase (ACC), indicating activation of rather pro-catabolic AMP-activated protein kinase (AMPK) signaling, consistent with increased ADP/ATP ratios and lower lipid peroxidation. Creatine addition to the soy-based diet (SOY + Cr vs. SOY) slightly increased left ventricular developed pressure (LVDP) and contractility dp/dt, as measured at baseline in perfused heart, and resulted in activation of the rather pro-anabolic protein kinases Akt and ERK. Challenging perfused heart with DXR, as analyzed across all nutritional regimens, deteriorated most cardiac functional parameters and also altered activation of the AMPK, ERK, and Akt signaling pathways. Despite partial reprogramming of cell signaling and metabolism in the rat heart, diet did not modify the functional response to supraclinical DXR concentrations in the used acute cardiotoxicity model. However, the long-term effect of these diets on cardiac sensitivity to chronic and clinically relevant DXR doses remains to be established.

Visually impaired people face numerous challenges in their everyday life, especially in outdoor environments. The most widely adopted mobility aids among the visually impaired community are white cane and guide dogs. With the advent of information and communication technologies (ICTs), they are now making use of smartphones and related services, e.g. GPS to assist them in navigation and everyday activities. Nevertheless, they still experience navigation difficulties in unfamiliar outdoor environments. Deep learning-based approaches have shown tremendous performance in various domains, e.g. computer vision, robotics, etc. which makes them an excellent choice for solving the navigation difficulties faced by visually impaired people. In this paper, we propose a learning-based outdoor navigation system to empower visually impaired people in their independent mobility. The approach builds upon two navigation strategies; namely macro- and micro-navigation. Further, we present our unique pedestrian-centric dataset. To evaluate the system performance, both navigation strategies were put to test. The results show the usability of the navigation system.

The controller design for a high-order object prone to oscillations under sufficient of interest in automation and robotics is being solved. For the first time, the square root in the error growth detector used as a component for the cost function calculating unit is proposed. Justification for this proposal is given, and the effectiveness of such modification of the cost function is demonstrated on example of object. Software SimInTech was used for some calculations. It was shown that strong procedures of optimization are wide necessary for controller design.

In this paper, we present a novel 4 camera stereo system for application as optical tracking component in navigation systems in computer-assisted surgery. This shall replace a common stereo camera system in several applications. The objective is to provide a tracking component consisting of four single industrial cameras. The system can be built up flexibly in the operating room e. g. at the operating room lamp. The concept is characterized by independent, arbitrary camera mounting poses and demands easy on-site calibration procedures of the camera setup. Following a short introduction describing the environment, motivation and advantages of the new camera system, a simulation of the camera setup and arrangement is depicted in Section 2. From this, we gather important information and parameters for the hardware setup, which is described in Section 3. Section 4 includes the calibration of the cameras. Here, we illustrate the background of camera model and applied calibration procedures, a comparison of calibration results obtained with different calibration programs and a new concept for fast and easy extrinsic calibration.

Currently, there is an intensive development of various variants of balancing robots, one-wheeled and two-wheeled ones. Two classes of two-wheeled robots can be distinguished: a) as on a Segway; b) as on a bicycle and a motorcycle. Both of these options are structurally unstable systems. Such structures without the use of an effective system of maintaining balance are fundamentally unstable, in the de-energized state they overturn. The equilibrium can be provided by a system with negative feedback. The development of a one-wheeled balancing robot in the version with an existing pilot has already been decided in practice, but driving such a vehicle requires a pilot with certain skills to ride it. In the unmanned version, all actions performed by the pilot must be replaced by an electromechanical system, which, firstly, provides an imbalance in order to set the direction and speed of movement through the system, which maintains this balance due to the rotation of the wheel, secondly, ensures the maintenance of equilibrium in the direction of the axis of this single wheel; thirdly, it forms the necessary effects for turning. Electromechanical propulsion can be a flywheel, a pendulum; one can also use a fan. At high speeds, it is also possible to use aerodynamic forces, for example, wings, but such a solution at the present stage of the development of technology should rather be considered exotic. However, a robot that is almost an aircraft due to lift from fans, wings or an air cushion may be the ideal solution for high-speed movements on a relatively flat surface. In this case, a purely symbolic touch of the ground, perhaps even interrupted when overcoming too deep and (or) short recesses, allows the robot to be classified as a ground-based (or jumping) device, which frees it from the formalities necessary for the legal use of flying unmanned aerial vehicles, formally such device is not flying mean. Accordingly, the movement of such a robot should be tied to the landmarks and possibilities of the route, its functions are also associated with ground objects, and the possibility of a short-term flight is only an additional bonus. These considerations make it relevant to consider such a way to resolve the issue of stabilizing the equilibrium of a one-wheeled robot, such as the use of lifting force of fans. However, the presence of the wheel creates other possibilities for the load-carrying capacity of the device, and so on; short-term hover by inertia requires completely different energy costs than continuous flight. The purpose of this study is to develop a set of technical proposals for the implementation of high-speed unmanned robot for informational purposes: information gathering (video, audio, electrometer, etc.), as well as for the removal and delivery of small loads. The objectives of the study are to analyze the existing technical solutions and a motivated proposal for the basic principles of the design of the specified balancing robot. A key feature of such robots should be steady motion in an unmanned version along a predetermined trajectory over rough terrain, including the slope of the terrain both in the direction of motion and in the direction orthogonal to the direction of motion.

The paper discusses the problem of balancing robot control with negative feedback loop. The regulator (controller) can be calculated by numerical optimization. Sensors of the controlled value are imperfect. Orientation angle sensor (gyroscope) has a limited speed, as well as binary quantization noise. An acceleration sensor (accelerometer) has the average value drift and Gaussian noise. None of these sensors is sufficient to effectively stabilize the balancing of the robot, but using them both in a single control loop can achieve the required accuracy of control in static and dynamic. Method of combining the two sensors to more accurately determine the value of a single, previously developed in theory, has been tested with simulation and with realization in acting model of the robot. The results are confirmed by their practical use with good effect, which one can see on video by the reference link.

Background. The aim of the third French Phosphorus and Calcium Observatory (Photo-Graphe (R) 3) was to assess the achievement of international Kidney Disease: Improving Global Outcomes (KDIGO) recommendations on optimal serum phosphate, calcium and parathyroid hormone (PTH) levels and possible associations with mortality in patients with chronic kidney disease (CKD). Methods. This was a prospective, observational study conducted with nephrologists in France who were selected using a clustering approach. Adult patients with non-dialysis Stage 4 or 5 CKD and no kidney graft history were eligible. Data about clinical events, serum biochemistry and treatment were collected every 6 months for 2.5 years and 12 months thereafter. The Kaplan-Meier method was used for survival analysis and Cox proportional hazards model for identification of factors associated with survival. Results. Overall, 566 CKD Stage 4 patients (men, 56%) and 153 CKD Stage 5 patients (men, 62%) were included. In Stage 4, only 14-15% patients achieved the three main 2009 KDIGO targets during the first 2 years and 22% at 2.5 years. In Stage 5 patients, the proportion remained <6% throughout. The percentages of patients achieving the three main 2017 KDIGO targets were slightly higher at each time point. Overall, 14% of Stage 4 and 10% of Stage 5 patients died in the observation period. Only age and haemoglobin level were significantly associated with risk of all-cause mortality. Conclusions. Few CKD patients achieved KDIGO mineral targets. Increased mortality risk was linked to older age and lower haemoglobin level, but not to serum calcium, phosphate or PTH targets.

Background: Abnormal serum phosphate, calcium and parathyroid hormone (PTH) levels in patients with chronic kidney disease (CKD) undergoing haemodialysis have been associated with poor survival. The French Phosphorus and Calcium Observatory (Photo-Graphe (R) 3) aimed to estimate the percentage of CKD patients achieving the three Kidney Disease: Improving Global Outcomes (KDIGO) targets about optimal serum phosphate, calcium and PTH over a 3.5-year follow-up period. Methods: This was a prospective, multicentre, epidemiological observational study conducted with nephrologists in France, selected using a clustering approach. Eligible patients were adults undergoing intermittent haemodialysis or haemodiafiltration therapy started within the preceding 12 months. Data about clinical events, serum biochemistry and treatment were collected once every 6 months for 2.5 years and 12 months thereafter. Results: Overall, 9010 incident patients were included (men, 63%; median age, 71 years) of whom 7515 (83.4%) were treated by haemodialysis and 1495 (16.6%) by haemodiafiltration. None had a history of fracture or revascularization while 89 (1%) patients had a history of parathyroidectomy >6 months. Overall, 874 (10%) patients received a kidney graft, 2183 (24%) died and 1148 (13%) were lost to follow-up. The proportion achieving the three KDIGO targets increased significantly from 11% to 16% (P < 0.0001) until Year 2, but remained stable afterwards. The percentage of incident dialysis patients with normal serum phosphate (P < 0.0001) or normal serum calcium (P < 0.0001) levels increased significantly over time, while no significant change was observed for those with controlled PTH. Conclusion: Less than 20% of patients achieved the KDIGO recommendations although their proportion increased slightly over time.

Scope: Decreasing postprandial glycaemic excursions may have a beneficial effect on inflammatory and oxidative stress profiles. In this study, we investigated the impact of carbohydrate digestibility modulation per se, as a means of reducing the glycaemic response, on metabolic and inflammatory responses in subjects with metabolic risk factors.Methods and results: Twenty healthy subjects with metabolic risk consumed a cereal product either high in Slowly Digestible Starch (HSDS) or low in SDS (LSDS) at breakfast daily for 3 weeks, in a cross‐over design. Following each 3‐week session, postprandial glycaemia, insulinaemia, the lipid profile, inflammation and oxidative stress markers were assessed and compared to those induced by ingestion of a glucose solution (as a reference). The 2‐h glycaemic and insulinaemic responses were significantly lower following the HSDS breakfast compared with the LSDS breakfast or glucose. No significant differences between the products were observed in terms of the lipid profile, C‐reactive protein, IL‐6 and tumour necrosis factor alpha. We observed a slight increase in fasting lipid peroxidation markers, including an increase in plasma malondialdehyde (MDA) and a decrease in whole blood glutathione (GSH), without significant alteration of urinary F2‐isoprostanes or plasma glutathione peroxidase (GPx) activity.Conclusion: Consumption of HSDS products for 3 weeks significantly altered both postprandial glycaemia and insulinaemia, but was not sufficient to modify the inflammatory profile. Consumption of both cereal products was associated with a slightly higher fasting oxidative stress profile.

Il y a peu de données sur la prise en charge des troubles du métabolisme minéral et osseux (TMO) de la maladie rénale chronique avant le stade de la dialyse en France. Une meilleure connaissance de la prise en charge actuelle pourrait conduire à une amélioration de l’implémentation des recommandations internationales (KDIGO). L’Observatoire national du métabolisme minéral et osseux Photo-Graphe (Sanofi), dans sa 3^e version, a inclus une cohorte de patients aux stades 4 et 5 de la maladie rénale chronique (MRC) dans le but d’examiner les TMO de la MRC ainsi que la qualité de leur prise en charge chez des patients suivis par 62 néphrologues répartis dans 20 régions françaises. Les TMO et leurs traitements ont été étudiés en octobre 2011, soit 1 an après l’inclusion des patients. Nous avons examiné en particulier le pourcentage de patients ayant une anomalie des paramètres biologiques reflétant les TMO, mais ne recevant pas de traitement adéquat selon les recommandations des KDIGO. Au total, 456 patients au stade 4 et 154 au stade 5 ont été étudiés, avec un âge moyen de 72,9 ± 14,2 ans et de sexe masculin dans 58 % des cas. Les cibles des KDIGO (stades 4 et 5) n’étaient pas atteintes dans respectivement 80 et 84 % des cas pour la PTH sérique, dans 8 et 22 % des cas pour la calcémie et dans 12 et 46 % des cas pour la phosphatémie. Une explication potentielle peut être une prise en charge médicamenteuse insuffisante estimée respectivement à 45 et 60 % pour l’hyperparathyroïdie secondaire (HPTS) et à 36 % pour l’hyperphosphatémie au stade 5. À noter que 55,5 et 57,5 % respectivement des patients aux stades 4 et 5 recevaient de la vitamine D native. Dans cet observatoire national, la prise en charge des TMO de la MRC aux stades 4 et 5 apparaît suboptimale, surtout pour ce qui concerne l’HPTS qui n’est pas traitée dans près de 50 % des cas. L’hyperphosphatémie est également fréquente et insuffisamment contrôlée au stade 5. Une amélioration de la prise en charge des TMO de la MRC passe par une sensibilisation des néphrologues à l’importance de viser les cibles biologiques et aux moyens d’y arriver. Only limited data is available on the management of the chronic kidney disease-associated bone and mineral metabolism disorder (CKD-MBD) in the pre-dialysis stages of CKD in France. A better knowledge of current management habits could lead to an improvement in the implementation of international recommendations (KDIGO). The 3rd version of the French Phosphorus and Calcium Survey Photo-Graphe (Sanofi) included a cohort of CKD stages 4 and 5 patients, whose aim was to examine the prevalence of CKD-MBD and the quality of its management in patients under the care of 62 nephrologists from over 20 geographical regions in France. The study started in October 2011, i.e. one year after patient enrollment. We examined in particular the percentage of patients presenting with laboratory parameter abnormalities indicative of CKD-MBD who were not receiving adequate treatment. A total of 456 patients with CKD stage 4 and 154 with CKD stage 5 were studied. Their mean age was 72.9 ± 14.2 years, and male/female ratio was 58/42. KDIGO targets of serum PTH for CKD stages 4 and 5 were not achieved in respectively 80 and 84% of the patients, for serum calcium in 8 and 22% and for serum phosphate in 12 and 46%. As a potential explanation, insufficient therapy was estimated to account for respectively 45 and 60% of insufficiently controlled secondary hyperparathyroidism, and for 36% of persistent hyperphosphatemia in stage 5. It should be noted that 55.5 and 57.5% of patients were receiving native vitamin D. In this national observatory, the management of CKD-MBD stages 4 and 5 appears suboptimal, especially as regards the control of secondary hyperparathyroidism, which remained untreated in nearly 50% of the patients. Hyperphosphatemia was also common and inadequately controlled in CKD stage 5. To improve the management of CKD-MBD, nephrologists need to be more aware of the importance of aiming for recommended laboratory targets and how this can be achieved.