Exoskeletons are a promising technology that enables individuals with mobility limitations to walk again.As the 2016 Cybathlon illustrated, however, the community has a considerable way to go before exoskeletons have the necessary capabilities to be incorporated into daily life. While most exoskeletons power only hip and knee flexion, Team Institute for Human and Machine Cognition (IHMC) presents a new exoskeleton, Mina v2, which includes a powered ankle dorsi/plantar flexion (Figure 1). As our entry to the 2016 Cybathlon Powered Exoskeleton Competition, Mina v2' s performance allowed us to explore the effectiveness of its powered ankle compared to other powered exoskeletons for pilots with paraplegia. We designed our gaits to incorporate powered ankle plantar flexion to help improve mobility, which allowed our pilot to navigate the given Cybathlon tasks quickly, including those that required ascending movements, and reliably achieve average, conservative walking speeds of 1.04 km/h (0.29 m/s). This enabled our team to place second overall in the Powered Exoskeleton Competition in the 2016 Cybathlon.

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Experience with 648 consecutive percutaneous transfemoral coronary arteriograms and left ventriculograms performed in a teaching laboratory without the use of systemic anticoagulation during the procedure was reviewed. Only 1 death was felt to be related to a procedure, and this occurred 3 weeks after a myocardial infarction. There were 10 myocardial infarctions or emboli, 8 cerebral vascular accidents, and 7 femoral artery complications. Only 1 patient experienced a residual neurologic change following a procedure-related cerebral vascular accident, and this was a mild visual field defect. Clotting of the catheter without sequelae but necessitating procedural changes occurred in 10 instances. The transient nature of the neurologic deficits and the low mortality suggest that the emboli which occurred in these patients were small, possibly platelet-fibrin accumulations. It is postulated that with the use of careful technic larger emboli capable of producing myocardial infarction with shock or disabling cerebral vascular accidents can be prevented, even in a training situation. However, smaller embolic phenomena probably cannot be completely avoided by the use of careful technic, and it is for prevention of small emboli that systemic anticoagulation with heparin may be of value.