Medicine and Health Sciences Commons^™

Hyperammonemia Of Unknown Cause In A Young Postpartum Woman: A Case Report, Sadaf Hanif, Sher Muhammad Sethi

Section of Internal Medicine

Background: Hyperammonemia is a medical condition described as increased or elevated serum ammonia levels. High serum levels of ammonia can cause neurotoxicity. Sudden onset severe hyperammonemia may cause severe encephalopathy with brain damage. It can result in cerebral edema, emesis, seizures, hypotonia, and death. We report a young postpartum woman who had a sudden rise in serum ammonia levels after vaginal delivery.
Case presentation: A 24-year-old, married, postpartum Pakistani woman was admitted to the intensive care unit through the emergency department, with complaints of fever, severe abdominal pain with distension, and altered levels of consciousness. The patient had a medical …

Aorta In Pathologies May Function As An Immune Organ By Upregulating Secretomes For Immune And Vascular Cell Activation, Differentiation And Trans-Differentiation-Early Secretomes May Serve As Drivers For Trained Immunity, Yifan Lu, Yu Sun, Keman Xu, Fatma Saaoud, Ying Shao, Charles Drummer, Sheng Wu, Wenhui Hu, Jun Yu, Satya P Kunapuli, John R Bethea, Roberto I Vazquez-Padron, Jianxin Sun, Xiaohua Jiang, Hong Wang, Xiaofeng Yang

Center for Translational Medicine Faculty Papers

To determine whether aorta becomes immune organ in pathologies, we performed transcriptomic analyses of six types of secretomic genes (SGs) in aorta and vascular cells and made the following findings: 1) 53.7% out of 21,306 human protein genes are classified into six secretomes, namely, canonical, caspase 1, caspase 4, exosome, Weibel-Palade body, and autophagy; 2) Atherosclerosis (AS), chronic kidney disease (CKD) and abdominal aortic aneurysm (AAA) modulate six secretomes in aortas; and Middle East Respiratory Syndrome Coronavirus (MERS-CoV, COVID-19 homologous) infected endothelial cells (ECs) and angiotensin-II (Ang-II) treated vascular smooth muscle cells (VSMCs) modulate six secretomes; 3) AS aortas upregulate …

Carveol Promotes Nrf2 Contribution In Depressive Disorders Through An Anti-Inflammatory Mechanism, Asmaa Jan Muhammad, Liangliang Hao, Lina Tariq Al Kury, Najeeb Ur Rehman, Arooj Mohsin Alvi, Haroon Badshah, Ikram Ullah, Fawad Ali Shah, Shupeng Li

All Works

Major depressive disorder (MDD) is a progressive deteriorating mental state with a feeling of worthlessness and frequent mood swings. Several studies reported the favorable effects of natural drug substances on MMD associated oxidative stress and neuroinflammation. The present study is attempted to examine whether carveol could affect lipopolysaccharide- (LPS-) induced depression, and if so, how nuclear factor E2-related factor (Nrf2) contributed to the neuroprotective effects of carveol mechanistically. Two experimental cohorts were used using the SD rats: first to evaluate the promising dose of carveol (whether 20 mg/kg or 50 mg/kg) and secondly to determine the effect of carveol on …

Therapists’ Perceptions Of The Carroll Upper Extremity Function Test To Measure Functional Outcomes Post-Hand Allotransplantation Based On Lived Experience, Jyoti Heiple

Graduate Theses, Dissertations, and Capstones

Hand allotransplantation is a treatment option available for individuals who have suffered a traumatic upper extremity injury. To date, there is not an industry-standard recognized measurement tool for assessing post-hand allotransplantation functional performance. A commonly used observational functional assessment tool is the Carroll Upper Extremity Function Test (UEFT). This dissertation explores therapists’ perceptions of the Carroll UEFT applicability to measure functional outcomes post-hand allotransplantation. The study employed a qualitative phenomenological approach with in-depth, semi-structured interviews with seven occupational and physical therapists representing five hand transplant centers in the United States. Braun and Clarke’s (2006) six-phase thematic analysis approach was utilized …

Using Implementation Mapping To Develop And Test An Implementation Strategy For Active Learning To Promote Physical Activity In Children: A Feasibility Study Using A Hybrid Type 2 Design, Timothy J Walker, Harold W Kohl, John B Bartholomew, Charles Green, Maria E Fernández

Faculty, Staff and Student Publications

BACKGROUND: Incorporating physical movement in the teaching of academic content (active learning) is a promising approach to improve children's health and academic performance. Despite documented benefits, implementation of active learning remains challenging for schools. The aims of this study are to develop an implementation strategy to support the delivery of active learning in elementary schools and examine the impact of the developed implementation strategy on the implementation and effectiveness of active learning.

METHODS: Aim 1 will use Implementation Mapping, which is a multi-step approach that guides the use of theory, stakeholder input, and existing literature to develop a scientifically based …

An Overlooked Epidemic: Pediatric Oral Health Concerns On The Rise In Rural Communities, Emma Verbrugge

Honors Program: Senior Projects (Public)

Pediatric oral health is a concern for many dentists and parents as they lay the foundation for long-term proper hygiene in children. Early childhood caries (ECC) is a disease of chronic tooth decay marked as the most common chronic disease of childhood in the world. Children living in rural areas are even more susceptible to this disease and thus significant attention is needed to curve these numbers. The consequences of ECC are much more than just cosmetic, but include heightened risk of gingivitis, periodontal disease, diabetes, cardiovascular disease, and much more. A foundational cause of poor dental hygiene lies with …

An Epidemiological, Strategic And Response Analysis Of The Covid-19 Pandemic In South Asia: A Population-Based Observational Study, Hafiz Muhammad Salman, Javaria Syed, Atif Riaz, Zouina Sarfraz, Azza Sarfraz, Syed Hashim Abbas Ali Bokhari, Ivan Cherrez Ojeda

Department of Paediatrics and Child Health

Introduction: South Asia has had a dynamic response to the ongoing COVID-19 pandemic. The overall burden and response have remained comparable across highly-burdened countries within the South Asian Region.
Methodology: Using a population-based observational design, all eight South Asian countries were analyzed using a step-wise approach. Data were obtained from government websites and publicly-available repositories for population dynamics and key variables.
Results: South Asian countries have a younger average age of their population. Inequitable distribution of resources centered in urban metropolitan cities within South Asia is present. Certain densely populated regions in these countries have better testing and healthcare facilities …

A Stakeholder-Driven Method For Selecting Implementation Strategies: A Case Example Of Pediatric Hypertension Clinical Practice Guideline Implementation, Ashley A Knapp, Byron J Powell, Et Al.

2020-Current year OA Pubs

BACKGROUND: This article provides a generalizable method, rooted in co-design and stakeholder engagement, to identify, specify, and prioritize implementation strategies. To illustrate this method, we present a case example focused on identifying strategies to promote pediatric hypertension (pHTN) Clinical Practice Guideline (CPG) implementation in community health center-based primary care practices that involved meaningful engagement of pediatric clinicians, clinic staff, and patients/caregivers. This example was chosen based on the difficulty clinicians and organizations experience in implementing the pHTN CPG, as evidenced by low rates of guideline-adherent pHTN diagnosis and treatment.

METHODS: We convened a Stakeholder Advisory Panel (SAP), comprising 6 pediatricians …

Strainge: A Toolkit To Track And Characterize Low-Abundance Strains In Complex Microbial Communities, Lucas R Van Dijk, Bruce J Walker, Timothy J Straub, Colin J Worby, Alexandra Grote, Henry L Schreiber 4th, Christine Anyansi, Amy J Pickering, Scott J Hultgren, Abigail L Manson, Thomas Abeel, Ashlee M Earl

2020-Current year OA Pubs

Human-associated microbial communities comprise not only complex mixtures of bacterial species, but also mixtures of conspecific strains, the implications of which are mostly unknown since strain level dynamics are underexplored due to the difficulties of studying them. We introduce the Strain Genome Explorer (StrainGE) toolkit, which deconvolves strain mixtures and characterizes component strains at the nucleotide level from short-read metagenomic sequencing with higher sensitivity and resolution than other tools. StrainGE is able to identify strains at 0.1x coverage and detect variants for multiple conspecific strains within a sample from coverages as low as 0.5x.

Interaction Analysis Of Mrp1 With Anticancer Drugs Used In Ovarian Cancer: In Silico Approach, Absarul Haque, Ghazanfar Ali Baig, Abdulelah Saleh Alshawli, Khalid Hussain Wali Sait, Bilal B. Hafeez, Manish Tripathi, Badrah Saeed Alghamdi, Hani S. H. Mohammed Ali, Mahmood Rasool

School of Medicine Publications

Multidrug resistance (MDR) is one of the major therapeutic challenges that limits the efficacy of chemotherapeutic response resulting in poor prognosis of ovarian cancer (OC). The multidrug resistance protein 1 (MRP1) is a membrane-bound ABC transporter involved in cross resistance to many structurally and functionally diverse classes of anticancer drugs including doxorubicin, taxane, and platinum. In this study, we utilize homology modelling and molecular docking analysis to determine the binding affinity and the potential interaction sites of MRP1 with Carboplatin, Gemcitabine, Doxorubicin, Paclitaxel, and Topotecan. We used AutoDock Vina scores to compare the binding affinities of the anticancer drugs against …

Intouch March 7, 2022, New York Medical College

InTouch

• Stephen R. Hammes, M.D., Ph.D., will Present the 33rd Annual GSRF Keynote Address
• Lauren M. Lang, LCSW, brings extensive, diverse experience to the SMHW
• The Purchasing Office Secures the Needs of the NYMC Community

Green Space And Heart Health: What’S The Connection?, Elizabeth A. Moxley

Faculty Articles, Papers, and Other Scholarship

While cardiovascular professionals across the globe are well-versed in applying guidelines-based care to help their patients prevent, or manage, cardiovascular disease, one important therapy may come not from a prescription bottle, but from just outside the front (or back) door. According to recent research, the key to improved cardiovascular health may be as simple as spending more time in nature. In fact, the health benefits from green space exposure are significant enough for practitioners and policymakers to recommend spending more time in nature.^1-8 It is becoming more common for health care providers in the U.S., Canada, and beyond to …

Glynac (Glycine And N-Acetylcysteine) Supplementation In Mice Increases Length Of Life By Correcting Glutathione Deficiency, Oxidative Stress, Mitochondrial Dysfunction, Abnormalities In Mitophagy And Nutrient Sensing, And Genomic Damage, Premranjan Kumar, Ob W Osahon, Rajagopal V Sekhar

Faculty, Staff and Students Publications

Determinants of length of life are not well understood, and therefore increasing lifespan is a challenge. Cardinal theories of aging suggest that oxidative stress (OxS) and mitochondrial dysfunction contribute to the aging process, but it is unclear if they could also impact lifespan. Glutathione (GSH), the most abundant intracellular antioxidant, protects cells from OxS and is necessary for maintaining mitochondrial health, but GSH levels decline with aging. Based on published human studies where we found that supplementing glycine and N-acetylcysteine (GlyNAC) improved/corrected GSH deficiency, OxS and mitochondrial dysfunction, we hypothesized that GlyNAC supplementation could increase longevity. We tested our hypothesis …

A Red Fluorescent Protein With Improved Monomericity Enables Ratiometric Voltage Imaging With Asap3, Benjamin B Kim, Haodi Wu, Yukun A Hao, Michael Pan, Mariya Chavarha, Yufeng Zhao, Michael Westberg, François St-Pierre, Joseph C Wu, Michael Z Lin

Faculty, Staff and Students Publications

A ratiometric genetically encoded voltage indicator (GEVI) would be desirable for tracking transmembrane voltage changes in the presence of sample motion. We performed combinatorial multi-site mutagenesis on a cyan-excitable red fluorescent protein to create the bright and monomeric mCyRFP3, which proved to be uniquely non-perturbing when fused to the GEVI ASAP3. The green/red ratio from ASAP3-mCyRFP3 (ASAP3-R3) reported voltage while correcting for motion artifacts, allowing the visualization of membrane voltage changes in contracting cardiomyocytes and throughout the cell cycle of motile cells.

Increased Dna Methylation, Cellular Senescence And Premature Epigenetic Aging In Guinea Pigs And Humans With Tuberculosis, Carly A Bobak, Abhimanyu, Harini Natarajan, Tanmay Gandhi, Sandra L Grimm, Tomoki Nishiguchi, Kent Koster, Santiago Carrero Longlax, Qiniso Dlamini, Jacquiline Kahari, Godwin Mtetwa, Jeffrey D Cirillo, James O'Malley, Jane E Hill, Cristian Coarfa, Andrew R Dinardo

Faculty, Staff and Students Publications

Background: Tuberculosis (TB) is the archetypical chronic infection, with patients having months of symptoms before diagnosis. In the two years after successful therapy, survivors of TB have a three-fold increased risk of death.

Methods: Guinea pigs were infected with Mycobacterium tuberculosis (Mtb) for 45 days, followed by RRBS DNA methylation analysis. In humans, network analysis of differentially expressed genes across three TB cohorts were visualized at the pathway-level. Serum levels of inflammation were measured by ELISA. Horvath (DNA methylation) and RNA-seq biological clocks were used to investigate shifts in chronological age among humans with TB.

Results: Guinea pigs …

Ezh2 And Endometrial Cancer Development: Insights From A Mouse Model, Xin Fang, Nan Ni, Xiaofang Wang, Yanan Tian, Ivan Ivanov, Monique Rijnkels, Kayla J Bayless, John P Lydon, Qinglei Li

Faculty, Staff and Students Publications

Enhancer of zeste homolog 2 (EZH2), a core component of polycomb repressive complex 2, plays an important role in cancer development. As both oncogenic and tumor suppressive functions of EZH2 have been documented in the literature, the objective of this study is to determine the impact of Ezh2 deletion on the development and progression of endometrial cancer induced by inactivation of phosphatase and tensin homolog (PTEN), a tumor suppressor gene frequently dysregulated in endometrial cancer patients. To this end, we created mice harboring uterine deletion of both Ezh2 and Pten using Cre recombinase driven by the progesterone receptor …

Depletion Of Transmembrane Mucin 4 (Muc4) Alters Intestinal Homeostasis In A Genetically Engineered Mouse Model Of Colorectal Cancer, Ramesh Pothuraju, Priya Pai, Sanjib Chaudhary, Jawed A Siddiqui, Jesse L Cox, Sukhwinder Kaur, Satyanarayana Rachagani, Hemant K Roy, Michael Bouvet, Surinder K Batra

Faculty, Staff and Students Publications

Mucins are components of the mucus layer overlying the intestinal epithelial cells, which maintains physiological homeostasis. Altered mucin expression is associated with disease progression. Expression of MUC4 decreases in colorectal cancer (CRC); however, its functional role and implications in the intestinal pathology in CRC are not studied well. Therefore, we generated a genetically engineered Muc4 knockout (Muc4-/-) CRC mouse model by crossing with Muc4-/- and Apc^flox/flox mice in the presence of colon-specific inducible Cre. We observed that deficiency of Muc4 results in an increased number of macroscopic tumors in the colon and rectal region and leads to poor survival. …

Lifeguard Performance Skills: A Systematic Review, Paulo Santiago, Filipe Maia, Sandra Santiago, Daniel Duarte, Pedro Teques

International Journal of Aquatic Research and Education

Drowning is one of the leading causes of death worldwide and lifeguards’ action can be regarded as a significant contribution to change that reality. In this regard, the purpose of this systematic review was to identify factors associated with lifeguards’ performance. After extensive research on PsycArticles, PsicBooks, PsycInfo, SportDiscus, Web of Science, PubMed, Scopus and SportDiscus databases, containing the keywords “lifeguard” AND “performance”, “lifeguard” AND “skills” and “lifeguard” AND “drowning”, we obtained 429 research articles. After eliminating duplicates, excluding those that had no relevance to the study, and screening against set criteria, a total of five articles were fully reviewed. …

Covid-19 Pandemic Life In Nm (2022), Daniel Lawrence Gavin, Isaac Reichsfeld

Making History Oral Histories

This video and transcription includes an interview with UNM student Isaac Reichsfeld. The topic of the interview was Covid-19 and its effects on normalcy in New Mexico 2022. During this time New Mexico had very strict restrictions to prevent the spread of Covid-19.

Intrathecal And Epidural Dexmedetomidine For Obstetric Patients, Sarah Tobias, Addison Hohner

Doctor of Nursing Practice Projects

The use of dexmedetomidine in spinals and epidurals can be beneficial for obstetric patients. The combination of dexmedetomidine with local anesthetics for neuraxial anesthesia potentiates the effect of the blockade while eliminating the undesirable side effects associated with opioid administration. This project used a non-experimental, pre-test/post-test design to assess key stakeholders' current use and intended future use of dexmedetomidine in neuraxial anesthesia for obstetrical patients. The goal of this project was to review current evidence-based literature regarding the use of dexmedetomidine as a neuraxial adjunct for obstetric anesthesia. The aim of this project was to summarize the results of the …

Safety Of Transcatheter Aortic Valve Replacement In Patients With Aortic Aneurysm: A Propensity-Matched Analysis, Justin K. Ugwu, Jideofor K. Ndulue, Khaled A. Sherif, Samson Alliu, Ayman Elbadawi, Tuncay Taskesen, Doha Hussein, Judith N. Ugwu Erugo, Khaled F. Chatila, Ahmed Almustafa

School of Medicine Publications

Introduction

There is a paucity of data regarding the outcomes of transcatheter aortic valve replacement (TAVR) among patients with thoracic or abdominal aortic aneurysms (AA). Using the Nationwide Inpatient Sample (NIS) database, we explored the safety of TAVR among patients with a diagnosis of AA.

Methods

We queried the National Inpatient Sample database (2012–2017) for hospitalized patients undergoing TAVR, using ICD-9 and ICD-10 codes for endovascular TAVR. Reports show that > 95% of endovascular TAVR in the US is via transfemoral access, so our population are mostly patients undergoing transfemoral TAVR. Using propensity score matching, we compared the trends and outcomes …

Gingival Transcriptome Of Innate Antimicrobial Factors And The Oral Microbiome With Aging And Periodontitis, Jeffrey L. Ebersole, Sreenatha Kirakodu, Linh Nguyen, Octavio A. Gonzalez

Dental Medicine Faculty Research

The epithelial barrier at mucosal sites comprises an important mechanical protective feature of innate immunity, and is intimately involved in communicating signals of infection/tissue damage to inflammatory and immune cells in these local environments. A wide array of antimicrobial factors (AMF) exist at mucosal sites and in secretions that contribute to this innate immunity. A non-human primate model of ligature-induced periodontitis was used to explore characteristics of the antimicrobial factor transcriptome (n = 114 genes) of gingival biopsies in health, initiation and progression of periodontal lesions, and in samples with clinical resolution. Age effects and relationship of AMF to the …

Graduate Session: Presentation 2 - Thinking Inside The Food Pantry Box, Elizabeth Shoaf

Life of the Scholar Multidisciplinary Conference

This presentation will evaluate the quality of food distributed at food pantries to clients with underlying health issues.

Validation Of Manipal Bedside Swallowing Screening Test For Assessing Aspiration In Individuals With Tracheostomy, Uzair Chilwan Mr.

Manipal College of Health Professions, Manipal Theses and Dissertations

ABSTRACTBackgroundThe availability of a standardised protocol that is exclusively focussed on assessing theswallowing concerns among tracheostomised individuals is limited.ObjectiveTo validate the Manipal Bedside Swallowing Screening Test (MBSST) for assessingaspiration in individuals with tracheostomy using Video Fluoroscopic Swallow Study(VFSS).MethodA total of 53 tracheostomized participants took part in the study where they were screened foraspiration at bedside as well as VFSS across three different consistencies. PenetrationAspiration Scale (PAS) was used to substantiate the severity of aspiration if present.ResultsThe test demonstrated both high sensitivity (91%; 95% confidence interval = 70.8-98.9) anddiagnostic accuracy (96%; 95% confidence interval = 87.0-99.5) for detecting aspiration inindividuals with …

Rotenone Induces Regionally Distinct Α-Synuclein Protein Aggregation And Activation Of Glia Prior To Loss Of Dopaminergic Neurons In C57bl/6 Mice, Savannah M Rocha, Collin M Bantle, Tawfik Aboellail, Debotri Chatterjee, Richard Jay Smeyne, Ronald B Tjalkens

Department of Neuroscience Faculty Papers

Rotenone is a naturally occurring insecticide that inhibits mitochondrial complex I and leads to neurochemical and neuropathological deficits closely resembling those in Parkinson's disease (PD). Deficits include loss of dopaminergic neurons (DAn) in the substantia nigra pars compacta (SNpc), decreased dopamine levels and aggregation of misfolded alpha-synuclein (p129). In rat models of rotenone-induced parkinsonism, the progression of neuronal injury has been associated with activation of microglia and astrocytes. However, these neuroinflammatory changes have been challenging to study in mice, in part because the systemic rotenone exposure model utilized in rats is more toxic to mice. To establish a reproducible murine …

Impact Of Stigma On Students With Attention-Deficit/Hyperactivity Disorder: Implications For School-Based Occupational Therapists, Sidney M. Mcreynolds Mrs.

Occupational Therapy Capstone Presentations

This study used the Attention/Deficit-Hyperactivity Disorder (ADHD) Stigma Questionnaire (ASQ) and the ADHD Implicit Relational Assessment Procedure (ADHD-IRAP) among school-based professionals, including occupational therapists. 24 occupational therapists and 23 other school professionals completed demographic questions and the ASQ. 22 completed scores were used for the ADHD-IRAP results. Other school professionals (36.17%) reported having experience with children with ADHD outside of their professional capacity more than occupational therapists (23.40%) which was marginally significant (F (0.96, 10.78) = [11.75], p = .051). On the ASQ subscales, there was a significant difference between groups for Self-Image (F (2.55,10.05) = [11.42], p = .002), …

Lipid Based Nanoparticles As A Novel Treatment Modality For Hepatocellular Carcinoma: A Comprehensive Review On Targeting And Recent Advances, Khaled Mahmoud, Shady Swidan, Mohamed A. El-Nabarawi, Mahmoud H. Teaima

Pharmacy

Liver cancer is considered one of the deadliest diseases with one of the highest disease burdens worldwide. Among the different types of liver cancer, hepatocellular carcinoma is considered to be the most common type. Multiple conventional approaches are being used in treating hepatocellular carcinoma. Focusing on drug treatment, regular agents in conventional forms fail to achieve the intended clinical outcomes. In order to improve the treatment outcomes, utilizing nanoparticles—specifically lipid based nanoparticles—are considered to be one of the most promising approaches being set in motion. Multiple forms of lipid based nanoparticles exist including liposomes, solid lipid nanoparticles, nanostructured lipid carriers, …

Knowledge And Practices On The Prevention And Management Of Diarrhea In Children Under-2 Years Among Women Dwelling In Urban Slums Of Karachi, Pakistan, Asif Khaliq, Amreen 1, Nazia Jameel, Stefanie J. Krauth

Department of Paediatrics and Child Health

Background: Diarrhea is the second leading cause of death especially among children. The age-proportionate mortality of diarrheal disease in infants under 2 years is 72%, among children under 5 years of age. Children living in urban slums are more prone to develop diarrhea. Although the disease can be prevented by many simple cost-effective interventions, i.e. proper sanitation and hygiene, appropriate feeding, and timely vaccination, poverty and lack of basic life amenities often potentiate diarrhea mortality. Gadap town is the largest town of Karachi with a deprived health system. This study aims to assess pediatric diarrhea prevalence and related knowledge-practice gaps …

Optimization Of The Musculoskeletal Simulation In Estimation Of Metabolic Cost, Arash Mohammadzadeh Gonabadi, Philippe Malcolm

UNO Student Research and Creative Activity Fair

Energy from food is supplied to the human body in the form of chemical energy in the muscles. This metabolic energy expenditure is one of the main determinants of the way we walk, and indirect calorimetry measurements are an essential tool for understanding how increases in metabolic cost restrict the mobility of clinical populations. Respiratory oxygen consumption measurements allow recording of the average metabolic cost of walking. However, the time required for these measurements prevents assessing metabolic rate in patients who cannot walk long enough. Musculoskeletal modeling techniques allow to estimate average muscle energy expenditure during locomotion in conjunction with …

How Can Actuation Timing And Magnitude Of A Bilateral Semi-Rigid Hip Exoskeleton Optimize Metabolic Cost, Arash Mohammadzadeh Gonabadi, Prokopios Antonellis, Sara Myers, Iraklis Pipinos, Philippe Malcolm

UNO Student Research and Creative Activity Fair

Semi-rigid exoskeletons could combine some advantages of rigid and soft approaches. The purpose of this study was to investigate the effects of timing and magnitude of assistance from a semi-rigid hip exoskeleton. For ten participants, we tested ten conditions that were combinations of 5 different end-timings, ranging from 21% to 49%, and 2 different moment magnitudes ranging from 0.06 to 0.12 Nm.kg^-1. The participants walked in two reference conditions: a condition without actuation and a condition without the exoskeleton. A semi-rigid hip exoskeleton could alter metabolic rate. However, to produce a net assistive effect, it is necessary to …