Baseline robot-measured kinematic metrics predict discharge rehabilitation outcomes in individuals with subacute stroke

Background: The literature on upper limb robot-assisted therapy showed that robot-measured metrics can simultaneously predict registered clinical outcomes. However, only a limited number of studies correlated pre-treatment kinematics with discharge motor recovery. Given the importance of predicting rehabilitation outcomes for optimizing physical therapy, a predictive model for motor recovery that incorporates multidirectional indicators of a patient’s upper limb abilities is needed.Objective: The aim of this study was to develop a predictive model for rehabilitation outcome at discharge (i.e., muscle strength assessed by the Motricity Index of the affected upper limb) based on multidirectional 2D robot-measured kinematics.Methods: Re-analysis of data from 66 subjects with subacute stroke who underwent upper limb robot-assisted therapy with an end-effector robot was performed. Two least squares error multiple linear regression models for outcome prediction were developed and differ in terms of validation procedure: the Split Sample Validation (SSV) model and the Leave-One-Out Cross-Validation (LOOCV) model. In both models, the outputs were the discharge Motricity Index of the affected upper limb and its sub-items assessing elbow flexion and shoulder abduction, while the inputs were the admission robot-measured metrics.Results: The extracted robot-measured features explained the 54% and 71% of the variance in clinical scores at discharge in the SSV and LOOCV validation procedures respectively. Normalized errors ranged from 22% to 35% in the SSV models and from 20% to 24% in the LOOCV models. In all models, the movement path error of the trajectories characterized by elbow flexion and shoulder extension was the significant predictor, and all correlations were significant.Conclusion: This study highlights that motor patterns assessed with multidirectional 2D robot-measured metrics are able to predict clinical evalutation of upper limb muscle strength and may be useful for clinicians to assess, manage, and program a more specific and appropriate rehabilitation in subacute stroke patients

〔報告〕ミャンマー共和国バガン遺跡ロカティーパン寺院壁画の保存修復と国際協力事業

Bagan is a Buddhist heritage site built between the 11th and 13th centuries by the first Burmese dynasty. The site houses more than 3,500 brick pagodas and temples, and the inner walls of some temples are completely covered with Buddhist wall paintings.Recent activities for the conservation of wall paintings in the Bagan heritage zone have been conducted as an emergency procedure; hence, full-fledged conservation and restoration have not been conducted. However, the main causes of active deterioration are correlated with the interaction of environmental factors (Temp/RH), and sealant materials applied during previous interventions are becoming a serious problem.The aim of the present project is to establish a working protocol that can be implemented on other wall paintings in the Bagan heritage zone and to continue undertaking local research surveys together with national and international experts

Non-thermal light-assisted resistance collapse in a V2_2O3_3-based Mott-insulator device

The insulator-to-metal transition in Mott insulators is the key mechanism for a novel class of electronic devices, belonging to the Mottronics family. Intense research efforts are currently devoted to the development of specific control protocols, usually based on the application of voltage, strain, pressure and light excitation. The ultimate goal is to achieve the complete control of the electronic phase transformation, with dramatic impact on the performance, for example, of resistive switching devices. Here, we investigate the simultaneous effect of external voltage and excitation by ultrashort light pulses on a single Mottronic device based on a V$_2$O$_3$ epitaxial thin film. The experimental results, supported by finite-element simulations of the thermal problem, demonstrate that the combination of light excitation and external electrical bias drives a volatile resistivity drop which goes beyond the combined effect of laser and Joule heating. Our results impact on the development of protocols for the non-thermal control of the resistive switching transition in correlated materials

SIAIP position paper: provocation challenge to antibiotics and non-steroidal anti-inflammatory drugs in children

Drug hypersensitivity reactions (DHRs) in childhood are mainly caused by betalactam or non-betalactam antibiotics, and non-steroidal anti-inflammatory drugs (NSAIDs). Laboratory tests for identifying children who are allergic to drugs have low diagnostic accuracy and predictive value. The gold standard to diagnose DHR is represented by the drug provocation test (DPT), that aims of ascertaining the causative role of an allergen and evaluating the tolerance to the suspected drug. Different protocols through the administration of divided increasing doses have been postulated according to the type of drug and the onset of the reaction (immediate or non immediate reactions). DPT protocols differ in doses and time interval between doses. In this position paper, the Italian Pediatric Society for Allergy and Immunology provides a practical guide for provocation test to antibiotics and NSAIDs in children and adolescents

Multidrug-resistant tuberculosis outbreak in an Italian prison: Tolerance of pyrazinamide plus levofloxacin prophylaxis and serial interferon gamma release assays

The optimal treatment for latent tuberculosis infection (LTBI) in subjects exposed to multidrug-resistant (MDR) tuberculosis (TB) remains unclear, and the change in response of the QuantiFERON-TB Gold In-Tube (QTB-IT) test during and after treatment is unknown. Between May 2010 and August 2010, 39 prisoners at the 'Casa Circondariale' of Modena, Italy, were exposed to a patient with active pulmonary MDR TB. All contacts were tested with the tuberculin skin test and QTB-IT. Upon exclusion of active TB, subjects positive to both tests were offered 6 months' treatment with pyrazinamide (PZA) and levofloxacin (LVX). QTB-IT testing was repeated at 3 and 6 months after initial testing in all subjects who were offered LTBI treatment. Seventeen (43.5%) of 39 subjects tested positive to both tuberculin skin test and QTB-IT test, and 12 (70.5%) agreed to receive therapy with PZA and LVX at standard doses. Only five (41.6%) of 12 subjects completed 6 months' treatment. Reasons for discontinuation were asymptomatic hepatitis, gastritis and diarrhoea. The QTB-IT values decreased in all subjects who completed the treatment, in two (33%) of six of those who received treatment for less than 3 months and in one (50%) of two patients who discontinued therapy after 3 months. The QTB-IT test results never turned negative. Despite the small number of subjects, the study confirmed that PZA plus LVX is a poorly tolerated option for MDR LTBI treatment. We observed a large degree of variation in the results of the QTB-IT test results among participants. The study confirmed that the interferon gamma release assay is not a reliable tool for monitoring the treatment of MDR LTBI in clinical practice

P15 Anti-carbamylated protein antibodies' levels are negatively correlated with circulating effector T-cells in a cohort of patients with systemic lupus erythematosus

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Effects of an intensive inpatient rehabilitation program in elderly patients with obesity

Objective: The aim of this study was to assess the short-term effectiveness of an intensive inpatient multidimensional rehabilitation program (MRP), including diet, exercise, and behavioral therapy, in elderly patients with severe obesity. Methods: Forty-four elderly patients (old; age 69.3 \ub1 3.5 years, BMI 41.9 \ub1 14.9) were analyzed against 215 younger patients (young; age 48.2 \ub1 18.5 years, BMI 43.9 \ub1 9.4), who were used as controls. All patients underwent MRP, based on group therapy guided by a multidisciplinary team (physicians, dietitians, exercise trainers, psychologists). We evaluated changes in anthropometry, cardiovascular risk factors, physical fitness, quality of life, and eating behavior. Results: After 3 weeks of MRP, we observed a reduction in body weight (old -3.8%, young -4.3%), BMI (old -3.9%, young -4.4%), waist circumference (old -3.4%, young -4.1%), total cholesterol (old -14.0%, young -15.0%), and fasting glucose (old -8.3%, young -8.1%), as well as improved performance in the Six-Minute-Walk Test (old +28.7%, young +15.3%), chair-stand test (old +24.8%, young +26.9%), and arm-curl test (old +15.2%, young +27.3%). Significant improvement was registered in all other analyzed domains. Conclusion: Our 3-week MRP provided significant clinical and functional improvement, which was similar between elderly and younger patients with severe obesity. In the long-term, this may be translated into better quality of life, through better management of obesity-associated morbidities and reduced frailty

A monocenter retrospective study of serological,histological and genetic characteristics of celiac disease in Northern Central Italy

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