Design and validation of a virtual player for studying interpersonal coordination in the mirror game

This is the author accepted manuscript. The final version is available from the publisher via the DOI in this record.The mirror game has been recently proposed as a simple, yet powerful paradigm for studying interpersonal interactions. It has been suggested that a virtual partner able to play the game with human subjects can be an effective tool to affect the underlying neural processes needed to establish the necessary connections between the players, and also to provide new clinical interventions for rehabilitation of patients suffering from social disorders. Inspired by the motor processes of the central nervous system (CNS) and the musculoskeletal system in the human body, in this paper we develop a novel interactive cognitive architecture based on nonlinear control theory to drive a virtual player (VP) to play the mirror game with a human player (HP) in different configurations. Specifically, we consider two cases: the former where the VP acts as leader and the latter where it acts as follower. The crucial problem is to design a feedback control architecture capable of imitating and following or leading a human player in a joint action task. Movement of the end-effector of the VP is modeled by means of a feedback controlled Haken-Kelso-Bunz (HKB) oscillator, which is coupled with the observed motion of the HP measured in real time. To this aim, two types of control algorithms (adaptive control and optimal control) are used and implemented on the HKB model so that the VP can generate a human-like motion while satisfying certain kinematic constraints. A proof of convergence of the control algorithms is presented in the paper together with an extensive numerical and experimental validation of their effectiveness. A comparison with other existing designs is also discussed, showing the flexibility and the advantages of our control-based approach.This work was funded by the European Project AlterEgo FP7 ICT 2.9 - Cognitive Sciences and Robotics, Grant Number 600610

Extra-Virgin Olive Oil Reduces Glycemic Response to a High-Glycemic Index Meal in Patients With Type 1 Diabetes: A Randomized Controlled Trial.

OBJECTIVE: To evaluate whether fat quality, in the context of meals with high- (HGI) or low-glycemic index (LGI), influences postprandial blood glucose (PPG) response in patients with type 1 diabetes. RESEARCH DESIGN AND METHODS: According to a randomized crossover design, 13 patients with type 1 diabetes on insulin pump consumed two series (HGI or LGI) of meals with the same carbohydrate quantity while differing for amount and quality of fat: 1) low in fat ("low fat"), 2) high in saturated fat (butter), or 3) high in monounsaturated fat (extra-virgin olive oil) (EVOO). Premeal insulin doses were based on insulin-to-glycemic load ratios. Continuous glucose monitoring was performed and 6-h PPG evaluated. RESULTS: PPG was significantly different between HGI and LGI meals (P = 0.005 for time × glycemic index interaction by repeated-measures analysis [RMA]), being significantly higher during the first 3 h after the HGI meals with a later tendency to an opposite pattern. In the context of HGI meals, PPG was significantly lower after EVOO than after low fat or butter (P < 0.0001 for time × meal interaction by RMA), with a marked difference in the 0- to 3-h glucose incremental area under the curve between EVOO (mean ± SD 198 ± 274 mmol/L × 180 min) and either low fat (416 ± 329) or butter (398 ± 355) (P < 0.05). No significant differences were observed in PPG between the three LGI meals. CONCLUSIONS: Carbohydrate quality of a mixed meal influences shape and extent of PPG. Besides, using EVOO in a HGI meal attenuates the early postprandial glucose response observed when this meal is consumed with either low fat or butter. Therefore, an optimal prandial insulin administration would require considering, in addition to the quantity of carbohydrates, the quality of both carbohydrate and fat

Il valore aggiunto della diagnostica molecolare nelle forme monogeniche di diabete mellito

Maturity Onset Diabetes of the Young (MODY), the most frequent form of monogenic diabetes, comprises a group of heterogeneous disorders, characterized by non-autoimmune diabetes due to mutations of at least 14 different genes. We report a case of a 38-years-old patient with non-autoimmune diabetes, where molecular analysis evidenced a large deletion on chromosome 17q12 including several genes, among them HNF1β associated to MODY5. The analysis allowed us to clarify the complex phenotype of the patient including, in addition to diabetes, intellectual disability, seizures, kidney cysts and facial dimorphisms. This case shows that diabetes when caused by large deletions, can be just one of the symptoms of a “clinical syndrome” that includes other features due to the deletion of neighboring genes and confirms the important role of the molecular test to obtain a correct diagnosis in a patient with a suspicion of monogenic diabetes

Performance of cytology and colposcopy in diagnosis of cervical intraepithelial neoplasia (CIN) in HIV-positive and HIV-negative women

As part of an extensive multi-institutional DIANAIDS-HIV-HPV-SIL project run in Italy (co-ordinated by ISS), the present study compares the performance (sensitivity, specificity, agreement) of routine cervical smear cytology with that of colposcopy in the detection of histologically-confirmed CIN lesions in 37 HIV-positive and 21 HIVnegative women, belonging to the DIANAIDS cohort of 459 women. All women were subjected to a cervical smear, colposcopy and biopsy, making possible the pairwise comparison of these techniques. In the whole series of HIV-positive and HIV-negative women, cytology had a sensitivity of 86.9% and specificity of 83.3%, the sensitivity of grade 2 abnormality on colposcopy against histology being 82.6% and specificity, 33.3%. No statistically significant difference was observed in the performance of Pap smears between the HIV-positive and HIV-negative women. The sensitivity of cytology was 89.7% vs 82.4% and the specificity, 75% vs 100%. For colposcopy, the sensitivity was 79.3% vs 88.2% and the specificity, 75% vs 50%. These data suggest that cervical Pap smear cytology is a highly sensitive and specific diagnostic tool in the clinical monitoring of lower genital tract pathology in HIV-positive women. Colposcopy, on the other hand, proved to be a somewhat less accurate diagnostic tool in these women